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

TitleA meta-analysis of six placebo-controlled trials of thiazolidinedione therapy for HIV lipoatrophy.
Publication TypeJournal Article
Year of Publication2010
AuthorsRaboud JM, Diong C, Carr A, Grinspoon S, Mulligan K, Sutinen J, Rozenbaum W, Cavalcanti RB, Wand H, Costagliola D, Walmsley S
Corporate AuthorsGlitazone and Lipoatrophy Meta-Analysis Working Group
JournalHIV Clin Trials
Volume11
Issue1
Pagination39-50
Date Published2010 Jan-Feb
ISSN1528-4336
KeywordsAdult, Body Fat Distribution, Female, HIV, HIV Infections, Humans, Lipodystrophy, Male, Middle Aged, Multivariate Analysis, Thiazolidinediones
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.

DOI10.1310/hct1101-39
Alternate JournalHIV Clin Trials
PubMed ID20400410
PubMed Central IDPMC3733492
Grant ListAI25924 / AI / NIAID NIH HHS / United States
AI27659 / AI / NIAID NIH HHS / United States
AI27663 / AI / NIAID NIH HHS / United States
AI27664 / AI / NIAID NIH HHS / United States
AI38858 / AI / NIAID NIH HHS / United States
AL38855 / / PHS HHS / United States
K23 DK 02844 / DK / NIDDK NIH HHS / United States
K23 DK002844 / DK / NIDDK NIH HHS / United States
M01 RR000083 / RR / NCRR NIH HHS / United States
M01 RR000088 / RR / NCRR NIH HHS / United States
M01 RR002635 / RR / NCRR NIH HHS / United States
M01-RR02635 / RR / NCRR NIH HHS / United States
M01-RR30088 / RR / NCRR NIH HHS / United States
R01 DK059535 / DK / NIDDK NIH HHS / United States
R01 DK59535 / DK / NIDDK NIH HHS / United States
RR00052 / RR / NCRR NIH HHS / United States
RR000750 / RR / NCRR NIH HHS / United States
RR00083 / RR / NCRR NIH HHS / United States
RR00096 / RR / NCRR NIH HHS / United States
U01 AI027659 / AI / NIAID NIH HHS / United States