4CPS-083 Evaluation of cardiovascular risk in patients on darunavir/cobicistat monotherapy treatment

Abstract

BackgroundSome of the most common adverse effects of protease inhibitors in treatment of HIV are dislypidaemia, diabetes and other metabolic disorders. These adverse effects should be recognised by health professionals so that they can perform an intervention to minimise the cardiovascular risk of the patient.PurposeTo analyse the impact of the metabolic adverse effects in HIV patients on darunavir/cobicistat monotherapy treatment.Material and methodsThis work is a descriptive observational study which took place in the outpatient consultation of a Hospital Pharmacy in a third-level hospital. We made a search of clinical variables as well as results of analytical tests. The variables included in this study were age, smoking habit, systolic blood pressure, presence of antihypertensive treatment, presence of diabetes mellitus, and HDL and total cholesterol serum concentrations at the beginning of treatment and at 6 and 12 months after. With these data, we calculated the Framingham Risk Score (FRS) at these months and we performed a statistical analysis.ResultsPatients (n=30) had a mean age of 50.2±11.6 years and 66.6% were males. They were all on treatment with a daily tablet of darunavir/cobicistat (800 mg/150 mg) as a single drug for HIV treatment. The median of FRS at the beginning of the treatment was 9.3 (3.9–22.7). At month 6 of treatment the median of FRS was 8.9 (4.2–20.8) and after 12 months was 8.9 (3.4–21.7). None of the patients had an increase of more than 4 points. A small group of patients (n=7) from this sample, who had an initial FRS over 25 were separately studied. Their mean FRS were 38.2 (28.4–39.4) at the beginning, 32.1 (28.9–36.4) at month 6 and 30.5 (25.2–37) at month 12. Five of these seven patients had a decrease in FRS of more than 4 points. Only one of them had an increase (2 points).ConclusionBased on these findings, we can affirm that there was no increase in the cardiovascular risk of the patients on treatment with darunavir/cobicistat, but there was also an improvement. Even patients at greater risk reduced their Framingham Risk Score. We want to show the importance of knowing the drugs deeply to prevent their adverse effects.No conflict of interest