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Impact of Rosiglitazone Treatment on the Bioavailability of Antiretroviral
Drugs in HIV Patients
Rosiglitazone is being studied for therapy of HIV-related
lipoatrophy, which is believed to stem from the use of antiretroviral
drugs. Little is known about potential pharmacological
interactions
between rosiglitazone and antiretroviral drugs. The primary aim
of the current German study was to learn more about potential interactions
between rosiglitazone and anti-HIV drugs.
Researchers
performed therapeutic drug monitoring (TDM) of ARV drugs in a prospective study before
and at day 28 after start of treatment with 4 mg of rosiglitazone
for combined lipodystrophy
syndrome (LDS). Drug levels were measured in the morning
fasting, and 0.5, 1, 2, 4, 6 and 8 h after standardized drug intake.
Results
· Twelve
males and six females were assessed; mean age was 50.7 years and
mean CD4 cell count was 496 cells/mm3;
· All
patients had a viral load below 50 copies/mL, and backbone ARV therapy
consisted of two or three nucleoside
reverse transcriptase inhibitors (NRTIs) in
all cases;
· After
administration of rosiglitazone, no significant differences in Cmax,
Cmin and AUC were found in cases treated with efavirenz
(Sustiva) (n
= 10) and lopinavir
(Kaletra) (n = 4);
· Mean
Cmax of nevirapine
(Viramune) (n = 4) was reduced significantly (-0.44).
In conclusion, the authors write, “Treatment with 4 mg of rosiglitazone
for HIV-associated LDS is likely to reduce the bioavailability of
nevirapine. Thus, routine TDM is recommended for patients treated
with rosiglitazone and nevirapine.”
“A
therapy consisting of efavirenz or lopinavir seems to be without
negative impact. Further studies on the interaction of rosiglitazone
with antiretroviral
(ARV) drugs are necessary.”
Clinic for Gastroenterology, Hepatology,
and Infectious Diseases, University Clinic Dusseldorf, Germany.
09/19/05
Reference
M Oette and others. Impact of rosiglitazone treatment on the bioavailability
of antiretroviral compounds in HIV-positive patients. Antimicrobial Chemotherapy 56(2):
416-419. Epub June 27, 2005.
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