| Rosiglitazone improves lipoatrophy in patients receiving thymidine-sparing regimens. | |
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MedLine Citation:
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PMID: 20453626 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Thymidine reverse transcriptase inhibitors (tNRTI) are strong inhibitors of PPAR-gamma and clearly implicated as a cause of lipoatrophy. Thiazolidenediaones (TZD), potent PPAR-gamma agonists, would be expected to be beneficial in HIV lipoatrophy, but prior studies have been conflicting. None specifically excluded the use of tNRTIs. We report the first study in individuals treated with tNRTI-sparing regimens using a TZD for treatment of HIV lipoatrophy. DESIGN: This double-blind, placebo-controlled study evaluated limb fat in HIV-infected individuals with lipoatrophy who discontinued tNRTI at least 24 weeks prior to enrollment. METHODS: Individuals were randomized to rosiglitazone vs. placebo for 48 weeks. Dual energy X-ray absorptiometry (DEXA)-scans and fasting metabolic assessments were serially performed. RESULTS: We enrolled 71 individuals, 17% were female and 51% white. Baseline characteristics were similar between groups except for higher total cholesterol in the placebo group (P = 0.04). At 48 weeks, limb fat (grams) increased significantly (P = 0.02) more in the rosiglitazone than in the placebo group: median (IQR) 448 (138, 1670) vs. 153 (-100, 682), respectively. Of lipids parameters, only total cholesterol increased significantly more in the rosiglitazone group (P = 0.008). Prevalence of metabolic syndrome and total bone mineral density did not change between or within groups. CONCLUSION: In the absence of tNRTI, rosiglitazone significantly improves lipoatrophy without deleterious effect on bone mineral density. Total cholesterol, but not triglycerides, significantly increased in the rosiglitazone arm. The glitazones may be a promising addition for accelerating fat recovery in individuals who had switched off tNRTI and remain with significant lipoatrophy. |
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Authors:
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Marisa Tungsiripat; Dalia El Bejjani; Nesrine Rizk; Mary Ann O'riordan; Allison C Ross; Corrilynn Hileman; Norma Storer; Danielle Harrill; Grace A McComsey |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: AIDS (London, England) Volume: 24 ISSN: 1473-5571 ISO Abbreviation: AIDS Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-18 Completed Date: 2010-12-30 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 8710219 Medline TA: AIDS Country: England |
Other Details:
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Languages: eng Pagination: 1291-8 Citation Subset: IM; X |
Affiliation:
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Cleveland Clinic, Ohio, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00367744 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Absorptiometry, Photon Adipose Tissue / drug effects* Adult Cholesterol / blood Double-Blind Method Female HIV Infections / blood, drug therapy HIV-Associated Lipodystrophy Syndrome / chemically induced, drug therapy*, metabolism Humans Male Middle Aged PPAR gamma / agonists, antagonists & inhibitors Reverse Transcriptase Inhibitors / adverse effects, therapeutic use* Thiazolidinediones / adverse effects, therapeutic use* Thymidine / antagonists & inhibitors |
| Grant Support | |
ID/Acronym/Agency:
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1UL 1RR024989/RR/NCRR NIH HHS; AI-060484/AI/NIAID NIH HHS; AI-070078/AI/NIAID NIH HHS; AI-36219/AI/NIAID NIH HHS; K23 AI070078-04/AI/NIAID NIH HHS; K23 AI070078-05/AI/NIAID NIH HHS; R01 AI060484-01A2/AI/NIAID NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/PPAR gamma; 0/Reverse Transcriptase Inhibitors; 0/Thiazolidinediones; 122320-73-4/rosiglitazone; 50-89-5/Thymidine; 57-88-5/Cholesterol |
| Comments/Corrections | |
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