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Rosuvastatin reduced inflammatory enzyme levels in HIV
In patients with HIV, treatment with rosuvastatin significantly reduced lipoprotein-associated phospholipase A2, or Lp-PLA2, an inflammatory enzyme associated with cardiovascular events in the general population, according to researchers from Emory University and Case Western Reserve University.
“This study offers novel data that support statin use in HIV as a means of decreasing inflammation,” the researchers wrote in The Journal of Infectious Diseases. “Increased [cardiovascular disease] in HIV is a growing concern, and measures to minimize this risk are urgently needed. Statin therapy in HIV-infected individuals, even in the absence of traditional risk factors, may hold promise.”
The researchers are conducting the SATURN-HIV trial, an ongoing, randomized, double blind, placebo-controlled trial to evaluate the role statins play on inflammatory markers in patients with HIV. The study includes 147 patients with HIV who were randomly assigned 10 mg rosuvastatin (Crestor, AstraZeneca) daily or placebo. All patients were assigned antiretroviral therapy, had LDL cholesterol of 130 mg/dL or less and had evidence of inflammation.
At the interim analysis at week 24, LDL cholesterol was reduced by 28% in the statin group and increased by 3.8% in the placebo group. In the statin group, the levels of Lp-PLA2 decreased by 10% vs. 2% in the placebo group. The absolute change of Lp-PLA2 was a decrease of 15 ng/mL in the statin group and 4 ng/mL in the placebo group. In a multivariable analysis, statin treatment and a CD4 nadir of 100 cells/mcL or lower were significant predictors of Lp-PLA2 decrease. There were no significant changes in other inflammatory markers between the groups.
“It remains to be seen if altering inflammation, and especially Lp-PLA2 concentrations, will affect CVD risk and plaque stability,” the researchers wrote. “However, further follow-up and assessment of changes in atherosclerotic burden and arterial stiffness are warranted.”
Disclosure: The researchers report no relevant financial disclosures.