Effect of Rosuvastatin on Endothelial Function
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Purpose
Rosuvastatin belongs to a class of medications commonly called "statins" which are medications given for high low density lipoprotein (LDL) 'bad' cholesterol to prevent atherosclerosis (hardening of blood vessels) and lower risk of heart attacks and other circulation problems. Recent studies in the general non-HIV infected population have shown that the beneficial effect of statins in preventing circulation problems is larger than would be expected from lowering of LDL-cholesterol alone. It has been suggested that the additional beneficial effect of statins may be due to the anti-inflammatory effect of statins.
The risk of heart attacks and other circulation problems may be high in HIV infected individuals. This may be due to the inflammatory stress effects of HIV. The main purpose of the study is to see if rosuvastatin will have a beneficial effect on the circulatory system in HIV infected individuals even in those who do not have high LDL cholesterol levels. Therefore, in HIV-infected individuals with normal or low LDL cholesterol levels but with evidence of low HDL cholesterol levels which may be a sign of low grade inflammation, the study will look at whether 3 months of rosuvastatin will lead to improvement in brachial artery flow-mediated dilatation (FMD), a marker of early atherosclerosis (hardening of the blood vessels).
| Condition | Intervention | Phase |
|---|---|---|
|
HIV Infections Cardiovascular Disease |
Drug: rosuvastatin |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Pilot Study of the Effect of Low-Dose Rosuvastatin on Endothelial Function, Oxidative Stress and Inflammatory Parameters in HIV-Infected Individuals With Low HDL Cholesterol Levels and Low to Normal LDL Cholesterol Levels |
- Change in flow mediated dilatation (FMD) of the brachial artery [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Change in HIV biomarkers of immune activation to include CD38 and CD69 expression on T cells and CD16 and CD69 expression on monocytes [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Change in mitochondrial-specific oxidative stress (mt-specific 8-oxo-dG) and oxidative phosphorylation (OXPHOS) protein/enzyme activity [Complex I and Complex IV] levels [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Change in glucose homeostasis and insulin resistance as assessed by oral glucose tolerance testing [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Change in total, HDL and LDL cholesterol and triglyceride levels [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- Change in hsCRP [ Time Frame: 3 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 20 |
| Study Start Date: | September 2009 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | August 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: rosuvastatin
rosuvastatin 10 mg qd increased to 20 mg qd as tolerated
|
Drug: rosuvastatin
rosuvastatin 20 mg tablet, 1/2 tab qd increased to a full tablet qd as tolerated x 6 months with optional extension to 2 years
Other Name: Crestor
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- HIV infection
- Age > 18 years old
- On stable antiretroviral therapy for > 6 months with no plans to change therapy during the treatment phase of the study
- Plasma HIV RNA < 50 copies/mL
- Karnofsky performance score > 70 within 30 days prior to study entry
- Ability to understand and sign informed consent
Following laboratory values obtained within 30 days prior to randomization:
- Absolute neutrophil count (ANC) > 750/mm3
- Hemoglobin >/= 8.0 g/dL
- Platelets >/= 50,000/mm3
- ALT (SGPT) and AST (SGOT) < 2.5 x ULN
- Fasting glucose < 126 mg/dL
- TSH < 3.0 mIU/L
- HDL-C < 50 mg/dL in men, < 55 mg/dL in women
- Direct LDL-C </= 130 mg/dL
- Calculated creatinine clearance > 50 mL/min
- Willing to be treated with rosuvastatin or be on an observational arm for a minimum of 3 months
- Female subject must not participate in a conception process (active attempt to become pregnant) or be post-menopausal. If participating in sexual activity that could lead to pregnancy, the subject must use contraception while receiving study medication and 30 days after stopping the medication
Exclusion criteria
- History of past cardiovascular event
- Acute illnesses or active AIDS-defining opportunistic infection (OI) within 30 days prior to entry
- Other chronic illness including diabetes, autoimmune diseases, and endocrinopathies
- Serology positive for hepatitis B surface antigen or hepatitis C antibody
- Signs and symptoms of liver failure
- Receipt of supraphysiologic glucocorticoid therapy within 3 months prior to study entry
- Use of lipid lowering agents within 30 days prior to study entry
- Receipt of an HIV vaccine or investigational agents
- Pregnancy or breast-feeding
- Presence of any active malignancy within the last 5 years
- Severe Hypertension (Systolic >/= 180 or Diastolic >/= 110 mm Hg)
- Use of oral postmenopausal hormone replacement therapy
- Known hypersensitivity to rosuvastatin
- Active drug or alcohol dependence
- Any acute illness within 30 days prior to study entry that, in the opinion of the site investigator, would interfere with participation in the study.
- Use of lopinavir/ritonavir (Kaletra) as part of current HIV antiretroviral regimen
Contacts and Locations| Contact: Lorna Nagamine, RN | 808 737-2751 ext 503 |
| United States, Hawaii | |
| Hawaii Center for AIDS | Recruiting |
| Honolulu, Hawaii, United States, 96816 | |
| Contact: Lorna Nagamine, RN 808-737-2751 | |
| Principal Investigator: Cecilia M Shikuma, MD | |
| Sub-Investigator: Todd Seto, M.D. | |
| Sub-Investigator: Dominic Chow, M.D. | |
| Sub-Investigator: Bruce Shiramizu, M.D. | |
| Sub-Investigator: Beau Nakamoto, M.D. | |
| Principal Investigator: | Cecilia Shikuma, MD | Hawaii Center for AIDS, John A. Burns School of Medicine, University of Hawaii |
More Information
No publications provided
| Responsible Party: | University of Hawaii |
| ClinicalTrials.gov Identifier: | NCT00986999 History of Changes |
| Other Study ID Numbers: | H002, R01HL095135 |
| Study First Received: | September 29, 2009 |
| Last Updated: | June 14, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of Hawaii:
|
HIV infected treatment experienced |
Additional relevant MeSH terms:
|
HIV Infections Acquired Immunodeficiency Syndrome Cardiovascular Diseases Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases |
Slow Virus Diseases Rosuvastatin Hydroxymethylglutaryl-CoA Reductase Inhibitors Anticholesteremic Agents Hypolipidemic Agents Antimetabolites Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Enzyme Inhibitors Lipid Regulating Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 22, 2013