In:
Antiviral Therapy, SAGE Publications, Vol. 12, No. 7 ( 2007-10), p. 1127-1132
Abstract:
Lopinavir/ritonavir-containing antiretro-viral therapy can cause hyperlipidaemia. However, most statins are contraindicated due to drug-drug interactions. Rosuvastatin undergoes minimal metabolism by CYP 450 , so no CYP 450 -based interaction with lopinavir/ritonavir is expected. This study explored the lipid-lowering effect of rosuvastatin and assessed the effect of lopinavir/ritonavir on the pharmacokinetics of rosuvastatin and vice versa. Methods HIV-infected patients on lopinavir/ritonavir (viral load 〈 400 copies/ml) with total cholesterol (TC) 〉 6.2 mmol/l were treated with rosuvastatin for 12 weeks, starting on 10 mg once daily. If fasting target values (TC 〈 5.0 mmol/l, high-density lipoprotein-cholesterol 〉 1.0 mmol/l, low-density lipoprotein-cholesterol [LDL-c] 〈 2.6 mmol/l and triglycerides 〈 2.0 mmol/l) were not reached, rosuvastatin was escalated to 20 mg or 40 mg at week 4 and 8, respectively. Plasma lopinavir/ritonavir trough levels (C min ) were determined at week 0, 4, 8 and 12 and rosuvastatin C min , at week 4, 8 and 12. Results Twenty-two patients completed the study. Mean reductions in TC and LDL-c from baseline to week 4 (on rosuvastatin 10 mg once a day) were 27.6% and 31.8%, respectively. Lopinavir/ritonavir concentrations were not influenced by rosuvastatin ( P=0.44 and 0.26, repeated-measures analysis). Median (interquartile range) rosuvastatin C min for 10 mg, 20 mg and 40 mg once daily were 0.97 (0.70–1.5), 2.5 (1.3–3.3) and 5.5 (3.3–8.8) ng/ml, respectively. Conclusions Rosuvastatin appeared to be an effective statin in hyperlipidaemic HIV-infected patients. Lopinavir/ritonavir levels were not affected by rosuvastatin, but rosuvastatin levels unexpectedly appeared to be increased 1.6-fold compared with data from healthy volunteers. Until safety and efficacy have been confirmed in larger studies, the combination of rosuvastatin and lopinavir/ritonavir should be used with caution.
Type of Medium:
Online Resource
ISSN:
1359-6535
,
2040-2058
DOI:
10.1177/135965350701200711
Language:
English
Publisher:
SAGE Publications
Publication Date:
2007
detail.hit.zdb_id:
2118396-X
SSG:
15,3
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