Arquivos Brasileiros de Cardiologia (Nov 2012)
Rosuvastatina e ciprofibrato no tratamento da dislipidemia em pacientes com HIV Rosuvastatin and ciprofibrate in the treatment of dyslipidemia in patients with HIV
Abstract
FUNDAMENTO: A dislipidemia secundária à terapia antirretroviral potente nos pacientes com HIV está associada à significativa elevação da morbimortalidade cardiovascular por doença aterosclerótica, sendo, portanto, necessário tratamento imediato e eficaz. OBJETIVO: Demonstrar a efetividade e a segurança da rosuvastatina e do ciprofibrato no tratamento da dislipidemia associada à terapia antirretroviral potente em pacientes com HIV. MÉTODOS: Trezentos e quarenta e seis pacientes com dislipidemia foram submetidos a tratamento farmacológico: 200 pacientes com hipertrigliceridemia receberam ciprofibrato (Grupo I); 79 pacientes com hipercolesterolemia receberam rosuvastatina (Grupo II); e 67 pacientes com dislipidemia mista receberam ciprofibrato associado a rosuvastatina (Grupo III). O perfil lipídico foi avaliado antes e após o tratamento hipolipemiante, sendo feita comparação estatística pelo teste de Wilcoxon. Transaminases hepáticas e creatinofosfoquinase foram dosadas para controle de toxicidade hepática e muscular. RESULTADOS: As concentrações séricas de triglicérides e de colesterol total foram significativamente menores do que as obtidas antes do tratamento, para os três grupos experimentais (p BACKGROUND: Dyslipidemia secondary to highly active antiretroviral therapy in patients with HIV is associated with a significant increase in cardiovascular morbidity and mortality due to atherosclerotic disease, requiring, thus, immediate and effective treatment. OBJECTIVE: To demonstrate the effectiveness and safety of rosuvastatin and ciprofibrate in the treatment of dyslipidemia associated with highly active antiretroviral therapy in patients with HIV. METHODS: Three hundred and forty-six patients with dyslipidemia underwent pharmacological treatment as follows: 200 patients with hypertriglyceridemia received ciprofibrate (Group I); 79 patients with hypercholesterolemia received rosuvastatin (Group II); and 67 patients with mixed dyslipidemia received ciprofibrate associated with rosuvastatin (Group III). The lipid profile was assessed before and after the lipid-lowering treatment, and the Wilcoxon test was used for statistical comparison. Liver transaminases and creatine phosphokinase were measured to assess liver and muscle toxicity. RESULTS: The serum concentrations of triglycerides and total cholesterol were significantly lower than those obtained before the lipid-lowering treatment in the three experimental groups (p < 0.002). A significant increase in HDL-cholesterol was observed in Groups I and III (p < 0.002). In Groups I and II, LDL-cholesterol was significantly lower (p < 0.001). None of the patients experienced elevations in transaminases or creatine phosphokinase to significantly toxic levels. CONCLUSION: The results of this study show that ciprofibrate and rosuvastatin or a combination of both can be considered an effective, safe and well-tolerated lipid-lowering treatment for patients with AIDS on highly active antiretroviral therapy.
