A meta-analysis of six placebo-controlled trials of thiazolidinedione therapy for HIV lipoatrophy.

Abstract:

OBJECTIVE:To determine the impact of thiazolidinediones (TZD) on changes in limb fat mass in HIV-infected individuals, particularly in those not receiving a thymidine analogue. METHODS:Individual patient data from placebo-controlled, randomized trials of rosiglitazone (n = 5) or pioglitazone (n = 1) were combined. Generalized estimating equation (GEE) models were used to estimate the treatment effect on changes in limb fat mass. RESULTS:In the combined dataset of 427 patients, the baseline median age was 45 years, 86% were male, 80% were Caucasian, 63% were receiving stavudine (d4T) or zidovudine (AZT), 66% were on protease inhibitors, and median body mass index was 23 kg/m(2). In a univariate GEE model, TZD was associated with an increase in limb fat mass (coeff = 0.14 kg vs placebo, P = .04). In a multivariable GEE model, patients receiving pioglitazone had significantly higher limb fat mass gains (coeff = 0.35 kg, P < or = .01) compared to patients receiving placebo, while patients on rosiglitazone did not (coeff = 0.05 kg, P = .48). Interactions between thymidine analogue use and rosiglitazone and pioglitazone were not significant. CONCLUSIONS:In this meta-analysis, pioglitazone therapy was more effective than placebo to increase limb fat mass whereas rosiglitazone was not significantly better than placebo. The effectiveness of these drugs did not vary according to whether the patients were receiving thymidine analogues.

journal_name

HIV Clin Trials

journal_title

HIV clinical trials

authors

Raboud JM,Diong C,Carr A,Grinspoon S,Mulligan K,Sutinen J,Rozenbaum W,Cavalcanti RB,Wand H,Costagliola D,Walmsley S,Glitazone and Lipoatrophy Meta-Analysis Working Group.

doi

10.1310/hct1101-39

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

39-50

issue

1

eissn

1528-4336

issn

1945-5771

pii

J11410W13135W7W2

journal_volume

11

pub_type

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