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Re-Examining Rosiglitazone for Lipoatrophy
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written by Jules Levin
At the 11th retrovirus Conference Andrew Carr presented an oral talk on the results of a study examining if rosiglitazone can improve lipoatrophy in HIV-infected individuals with lipoatrophy. He reported that they did not find improvement. Rosi- is an antidiabetic drug that it was thought could improve fat loss in HIV-infected patients with fat loss. Steve Grinspoon reported early data from his study at the Lipodystrophy Workshop in Paris suggesting it might improve fat loss in individuals with insulin resistance. Below is a link to the published study report he filed in The Lancet (Feb 2004). In the Baseline Characteristics for the study patients, 32% of patients in both the placebo & rosi- groups were taking abacavir (Ziagen). Several studies including MITOX found that abacavir may improve lipoatrophy for patients switching from d4T to abacavir. The question is: if 32% of patients in Carr's study were already taking abacavir before initiating rosiglitazone, how would this affect the outcome of the study? If study patients who were in the placebo arm of the study had switched from d4T to abacavir and sawan improvement in fat loss this could mask a difference between the two study arms: one study arm received placebo and another received rosiglitazone.
Therefore, this suggests the door is not closed on the possibility that rosiglitazone might improve lipoatrophy. I think discussion regarding this will continue.
No effect of rosiglitazone for treatment of HIV-1 lipoatrophy: randomised,double-blind, placebo-controlled trial
http://www.natap.org/2004/CROI/croi_11.htm
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