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Reduced visceral adipose tissue improved metabolic profile in HIV
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Improvements were observed in the metabolic profiles of patients with HIV assigned tesamorelin who experienced an 8% or more reduction in visceral adipose tissue, according to data from a recent study.
“Tesamorelin is effective at reducing visceral fat and improving waist circumference, triglyceride levels and quality of life among patients with HIV and abdominal fat accumulation in the context of antiretroviral therapy,” Steven Grinspoon, MD, professor of medicine at Harvard Medical School and director of the Massachusetts General Hospital program in nutritional metabolism, told Infectious Disease News. “The more the visceral fat is reduced, the more these other parameters improve, suggesting that there is an important benefit to reducing visceral fat in this population.”
Steven Grinspoon
Grinspoon and other researchers from the program in nutritional metabolism at Massachusetts General Hospital and Harvard Medical School conducted two phase 3, randomized, double blind studies in which men and women with HIV-associated abdominal fat accumulation were randomly assigned to receive tesamorelin or placebo for 26 weeks. Patients who received tesamorelin were again randomly assigned to receive tesamorelin or placebo for another 26 weeks. Those who originally received placebo were switched to tesamorelin.
For the current study, the differences between those who responded to tesamorelin and those who did not respond were assessed. Three hundred thirty-seven participants receiving tesamorelin who had data on visceral adipose tissue at baseline and 26 weeks were included in the 26-week analysis. For the 52-week analysis, 152 participants who had baseline and 52-week data on visceral adipose tissue were included. The responder rate was higher among those treated with tesamorelin.
Responders demonstrated significantly greater decreases in waist circumference than nonresponders: The mean change in waist circumference among responders was –4.7 cm after 52 weeks. Changes in subcutaneous adipose tissue were also significant, with responders experiencing small decreases and nonresponders demonstrating small increases.
In addition, insulin-like growth factor I levels were significantly increased in responders vs. nonresponders. Adiponectin levels also increased in responders, but not nonresponders. Triglyceride levels decreased significantly more in responders vs. the nonresponders at both the 26-week and 52-week analyses. There was also improvement in fasting glucose levels and HbA1c levels among responders.
“Future research should assess effects on other fat depots, including on liver fat as well as specific atherosclerotic indices,” Grinspoon said. “Longer-term studies are also needed to determine safety with long-term use.”
References:
Stanley TL. Clin Infect Dis. 2012;54:1642-1650.
Disclosures:
Some of the researchers have received research support and have other financial interests in Abbott Canada, Bristol-Myers Squibb Canada, EMD Serono, Gilead Canada, Merck Canada, Theratechnologies and ViiV Canada. Five researchers are employees of Theratechnologies.