Here's one for all of you lurking analysts, reporters, and McC's that learn everything you know about Agouron from this thread (and never acknowledge that the information is here first, free)......
"Of 133 patients receiving protease inhibitors, those who took
saquinavir and ritonavir were significantly more likely to have raised lipid concentrations"........
Lancet 352: 1031, 1998; Henry K., Melroe H., Huebesch J., et al.
Atorvastatin and Gemfibrozil for Protease-Inhibitor-Related Lipid
Abnormalities (Research Letter)
Scientists from Minnesota report the treatment of HIV-positive patients with
both protease inhibitors and the lipid-reducing agents gemfibrozil and/or
atorvastatin. Of 133 patients receiving protease inhibitors, those who took
saquinavir and ritonavir were significantly more likely to have raised lipid
concentrations meeting intervention criteria as outlined by the National
Cholesterol Education Program (NCEP). Forty-four patients were enrolled in
intervention programs. Twenty patients with lower increased lipid
concentrations were started on exercise and diet programs, while the others
were given gemfibrozil and/or atorvastatin. Twelve of the exercise and diet
program patients were judged treatment failures and started on the
lipid-lowering agents. Of those on gemfibrozil alone, 19 had sub-optimum
responses and had atorvastatin added to their regimen. Patients who
received both medications showed decreases in their lipid levels, with
triglyceride concentration falling 60 percent over six months and mean
cholesterol concentration declining 30 percent. The authors note that NCEP
guidelines advise using caution in the combination of statins and
gemfibrozil since there is a concern for increased risk of myopathy. There
may also be increased toxicity when atorvastatin is used with cytochrome
p450-interfering medications, such as protease inhibitors. However, the
researchers observed no instances of myopathy, raised creatine kinase of
liver enzymes, or adverse virologic effects, and they suggest that raised
lipid concentrations in HIV-infected patients on protease inhibitors can be
managed by following NCEP guidelines.
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