IAS 2019 — Rosuvastatin is not protective against atherosclerotic progression in people with HIV


  • Myriam Vidal Valero
  • Conference Reports
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Takeaway

  • Rosuvastatin in patients with HIV at moderate cardiovascular risk did not alter atherosclerosis progression vs placebo at 96 weeks.
  • Drug yielded predictable effects on total and low-density lipoprotein cholesterol (LDL-C). 

Why this matters

  • Risk scores for myocardial infarction lack sensitivity and specificity in people with HIV.
  • Benefits of statin therapy in patients with HIV at low-moderate risk may not justify the potential harms.

Key results

  • No difference seen between placebo and treatment groups in progression of intima-media thickness from baseline to 96 weeks at any site (all P>.05).
  • More adverse events in the treatment group.
  • Expected effects seen for total cholesterol and LDL-C: mean change −1.06 mmol/L with drug vs −0.06 mmol/L with placebo; P<.0001.>

Study design

  • Randomized, double-blinded, placebo-controlled, multinational trial comparing placebo and rosuvastatin for 96 weeks in people with HIV (stable antiretroviral regimen >3 months; viral load
  • Participants were randomly allocated 1:1 (stratified by site) to 20 mg/day rosuvastatin or matched placebo.
  • Outcome: atherosclerotic progression (estimated by change in carotid intima-media thickness).

Limitations

  • Results were presented without peer review at a conference.

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