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Greater remnant lipoprotein cholesterol reduction with pitavastatin compared with pravastatin in HIV-infected

Parag H Joshi1, P Elliott Miller, Seth S Martin

  • 1aDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas bJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore cDepartment of Critical Care Medicine, National Institutes of Health, Bethesda, Maryland dDepartment of Biostatistics, Boston University School of Public Health, Boston, Massachusetts eAtherotech Diagnostics Laboratory, Birmingham fKowa Pharmaceuticals America, Inc., Montgomery, Alabama gCGH Medical Center, University of Illinois School of Medicine, Peoria, Illinois, USA.

AIDS (London, England)
|January 26, 2017
PubMed

Insights

Pitavastatin significantly reduced remnant lipoprotein cholesterol (RLP-C) and other cardiovascular disease risk factors in HIV patients more than pravastatin. Further study is needed on RLP-C reduction

Area of Science:

  • Cardiology
  • HIV Medicine
  • Lipidology

Background:

  • Cardiovascular disease (CVD) is a major cause of death in HIV patients.
  • Elevated remnant lipoprotein cholesterol (RLP-C) is an emerging CVD risk factor in this population.
  • The effect of statins on RLP-C in HIV dyslipidemia is not well understood.

Purpose of the Study:

  • To compare the effects of pitavastatin and pravastatin on lipoprotein subfractions, including RLP-C, in HIV patients with dyslipidemia.
  • To evaluate changes in atherogenic lipid profiles over 12 weeks.

Main Methods:

  • Post hoc analysis of the randomized INTREPID trial.
  • Comparison of pitavastatin 4 mg/day versus pravastatin 40 mg/day in HIV patients.
  • Measurement of apolipoproteins and lipoprotein cholesterol subfractions at baseline and 12 weeks.

Main Results:

  • Pitavastatin demonstrated significantly greater reductions in RLP-C compared to pravastatin (-11.6 mg/dL vs. -8.5 mg/dL; P=0.01).
  • Greater reductions in risk ratios (ApoB/ApoAI, TC/HDL-C) were observed with pitavastatin (P<0.05).
  • No significant differences were found in HDL-C, its subfractions, or lipoprotein(a) cholesterol levels between the groups.

Conclusions:

  • Pitavastatin 4 mg/day effectively lowered RLP-C and other established cardiovascular risk markers more than pravastatin 40 mg/day in HIV patients.
  • The clinical impact of RLP-C reduction on CVD risk in HIV dyslipidemia warrants further investigation.
Abstract

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