Use of ezetimibe during HIV infection

Stebbing, Justin; Asghar, Arfaa; Holmes, Paul; Bower, Mark; Isenman, Heather; Nelson, Mark

doi:10.1093/jac/dkn440

Cited by 5 publications

(1 citation statement)

References 7 publications

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“…No adverse events occurred. Stebbin et al [39] analyzed twenty nine HIV-infected persons with ezetimibe alone or associated with statins. Of these individuals, 16 and 11 respectively were receiving PI-based and NNRTI-based regimen.…”

Section: Pathogenesis For Dyslipidemiamentioning

confidence: 99%

New Options in the Treatment of Lipid Disorders in HIV-Infected Patients

Silva¹,

Bárbaro²

2009

TOAIDJ

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Since the introduction of HAART, there was a remarkably change in the natural history of HIV disease, leading to a notable extension of life expectancy, although prolonged metabolic imbalances could significantly act on the longterm prognosis and outcome of HIV-infected persons, and there is an increasing concern about the cardiovascular risk in this population. Current recommendations suggest that HIV-infected perons undergo evaluation and treatment on the basis of the Third National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP ATP III) guidelines for dyslipidemia, with particular attention to potential drug interactions with antiretroviral agents and maintenance of virologic control of HIV infection. While a hypolipidemic diet and physical activity may certainly improve dyslipidemia, pharmacological treatment becomes indispensable when serum lipid are excessively high for a long time or the patient has a high cardiovascular risk, since the suspension or change of an effective antiretroviral therapy is not recommended. Moreover, the choice of a hypolipidemic drug is often a reason of concern, since expected drug-drug interactions (especially with antiretroviral agents), toxicity, intolerance, effects on concurrent HIV-related disease and decrease patient adherence to multiple pharmacological regimens must be carefully evaluated. Often the lipid goals of patients in this group are not achieved by the therapy recommended in the current lipid guidelines and in this article we describe other possibilities to treat lipid disorders in HIV-infected persons, like rosuvastatin, ezetimibe and fish oil.

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Section: Pathogenesis For Dyslipidemiamentioning

confidence: 99%

New Options in the Treatment of Lipid Disorders in HIV-Infected Patients

Silva¹,

Bárbaro²

2009

TOAIDJ

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Ezetimibe – a new approach in hypercholesterolemia management

Suchy

Łabuzek

Stadnicki

2011

Pharmacological Reports

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Ezetimibe is the first agent used in hypercholesterolemia treatment known to lower intestinal cholesterol uptake that is able to inhibit NPC1L1 transport proteins in the brush boarder of enterocytes and macrophages. Furthermore, it demonstrates anti-inflammatory and immunomodulatory properties and influences the expression of certain antigens. The drug is rapidly absorbed from the gastrointestinal tract and is then glucuronidated to form the active metabolite. It also undergoes extensive enterohepatic circulation. Various genetic polymorphisms seem to influence the pharmacokinetics of ezetimibe with different effects. The drug also presents a complex impact on cytochrome P450 enzymes, as it is a metabolism-dependent inhibitor of CYP3A4. Ezetimibe does not demonstrate any clinically significant interactions with statins, fibrates, mipomersen sodium, levothyroxine or lopinavir. However, its effect in conjunction with cyclosporine is not neutral. The use of this cholesterol absorption inhibitor has been shown to be safe and effective among patients after cardiac, renal and liver transplants, as well as in HIV patients.

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