Use of rosuvastatin in HIV-associated chronic obstructive pulmonary disease

作者：Morris Alison^*; Fitzpatrick Meghan; Bertolet Marnie; Qin Shulin; Kingsley Lawrence; Leo Nicolas; Kessinger Cathy; Michael Heather; Mcmahon Deborah; Weinman Renee; Stone Stephen; Leader Joseph K; Kleerup Eric; Huang Laurence; Wisniewski Stephen R

来源：AIDS, 2017, 31(4): 539-544.

DOI：10.1097/QAD.0000000000001365

• chronic obstructive pulmonary disease
• HIV
• inflammation
• lung
• statin

Objectives: Chronic obstructive pulmonary disease (COPD) is more prevalent in HIV-infected individuals and is associated with persistent inflammation. Therapies unique to HIV are lacking. We performed a pilot study of the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor rosuvastatin to determine effects on lung function. Design: Randomized, placebo-controlled, triple-blinded trial.
Methods: HIV-infected individuals with abnormal lung function were recruited from an ongoing lung function study. Participants were randomized to 24 weeks of placebo (n = 11) or rosuvastatin (n = 11) using an adaptive randomization based on change in peripheral C-reactive protein levels at 30 days of treatment. Forced expiratory volume in 1 s (FEV1) and diffusing capacity for carbon monoxide (DLco)%-predicted were compared to baseline at 24 weeks in the two groups using a Wilcoxon rank-sum test. The %-predicted change at 24 weeks in pulmonary function variables was compared between groups using simulated randomization tests.
Results: The placebo group experienced a significant decline in FEV1%-predicted (P - 0.027), and no change in DLco%-predicted over 24 weeks. In contrast, FEV1%-predicted remained stable in the rosuvastatin group, and DLco%-predicted increased significantly (P = 0.027). There was no significant difference in absolute change in either measure between placebo and rosuvastatin groups.
Conclusion: In a pilot study, the use of rosuvastatin for 24 weeks appeared to slow worsening of airflow obstruction and to improve DLco in HIV-infected individuals with abnormal lung function, although comparison of absolute changes between the groups did not reach significance. This study is the first to test a therapy for COPD in an HIV-infected population, and large-scale clinical trials are needed.

• 出版日期2017-2-20