Improvement of BMD after Switching from Lopinavir/R Plus Two Nucleos(T)ide Reverse Transcriptase Inhibitors to Lopinavir/R Plus Lamivudine: OLE-LIP Substudy
Por:
Crespo, M, Navarro, J, Martinez-Rebollar, M, Podzamczer, D, Domingo, P, Mallolas, J, Saumoy, M, Mateo, GM, Curran, A, Gatell, J, Ribera, E
Publicada:
1 ene 2016
Resumen:
Objective: To compare 48-week changes in bone mineral density (BMD) and body fat distribution between patients continuing lopinavir/ritonavir and two NRTIs and those switching to lopinavir/ritonavir and lamivudine.
Methods: Substudy of a randomized, open-label, multicenter OLE study was carried out. Adult HIV-infected patients with <50 copies/mL for >= 6 months were randomized (1:1) to continue lopinavir/ritonavir and two NRTIs or switching to lopinavir/ritonavir and lamivudine. Dual-energy X-ray absorptiometry (DXA) was performed at baseline and after 48 weeks to measure bone composition and body fat distribution in both the groups.
Results: Forty-one patients (dual-therapy, n = 23; triple-therapy, n = 18) of 239, who received at least one dose of study medication, completed the study: median age, 42 years, 71% male, 73% Caucasian. At week 48, total BMD increased by 1.04% (95% CI, 0.06 to 2.01%) among patients switching to dual-therapy, whereas no significant changes occurred in patients maintaining triple-therapy. Dual-therapy and older age were independently associated with total BMD increase. Among patients discontinuing tenofovir-DF, a significant increase was seen in total BMD (1.43; 95% CI, -0.04 to 2.91) and total hip (1.33%; 95% CI, 0.44 to 2.22%). A non-statistically significant decrease in femoral and spinal BMD was observed in patients who discontinued abacavir and in those continuing triple-therapy. Regarding fat distribution, no significant changes were seen in both the treatment groups.
Discussion: BMD increased following switching to lopinavir/ritonavir plus lamivudine in HIV-infected patients on suppressive triple-therapy with lopinavir/ritonavir and two NRTIs including tenofovir-DF.
Filiaciones:
Crespo, M:
Autonomous Univ Barcelona, Hosp Univ Vall dHebron, Barcelona, Spain
Vall dHebron Res Inst, Barcelona, Spain
Navarro, J:
Autonomous Univ Barcelona, Hosp Univ Vall dHebron, Barcelona, Spain
Vall dHebron Res Inst, Barcelona, Spain
Martinez-Rebollar, M:
Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain
Podzamczer, D:
Hosp Univ Bellvitge, Barcelona, Spain
Domingo, P:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Mallolas, J:
Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain
Saumoy, M:
Hosp Univ Bellvitge, Barcelona, Spain
Mateo, GM:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Curran, A:
Autonomous Univ Barcelona, Hosp Univ Vall dHebron, Barcelona, Spain
Gatell, J:
Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain
Ribera, E:
Autonomous Univ Barcelona, Hosp Univ Vall dHebron, Barcelona, Spain
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