Bone mineral density in HIV participants randomized to raltegravir and lopinavir/ritonavir compared with standard second line therapy
Identifieur interne : 005070 ( Main/Exploration ); précédent : 005069; suivant : 005071Bone mineral density in HIV participants randomized to raltegravir and lopinavir/ritonavir compared with standard second line therapy
Auteurs : Allison Martin [Australie] ; Cecilia Moore [Australie] ; Patrick W. G. Mallon [Irlande (pays)] ; Jennifer Hoy [Australie] ; Sean Emery [Australie] ; Waldo Belloso [Argentine] ; Praphan Phanuphak [Thaïlande] ; Samuel Ferret [France] ; David A. Cooper [Australie] ; Mark A. Boyd [Australie]Source :
- AIDS : (London) [ 0269-9370 ] ; 2013.
Descripteurs français
- KwdFr :
- Absorptiométrie photonique, Adulte, Argentine (épidémiologie), Densité osseuse (), Facteurs de risque, Femelle, Fémur (imagerie diagnostique), Humains, Inde (épidémiologie), Infections à VIH (), Infections à VIH (traitement médicamenteux), Inhibiteurs de la transcriptase inverse (administration et posologie), Inhibiteurs de la transcriptase inverse (effets indésirables), Inhibiteurs de protéase du VIH (administration et posologie), Inhibiteurs de protéase du VIH (effets indésirables), Lopinavir (effets indésirables), Maladies osseuses métaboliques (), Maladies osseuses métaboliques (épidémiologie), Malaisie (épidémiologie), Mâle, Ostéoporose (), Ostéoporose (épidémiologie), Prévalence, Pyrrolidones (effets indésirables), Raltégravir de potassium, Ritonavir (effets indésirables), République d'Afrique du Sud (épidémiologie), Résultat thérapeutique, Thaïlande (épidémiologie), Vertèbres lombales (imagerie diagnostique).
- MESH :
- administration et posologie : Inhibiteurs de la transcriptase inverse, Inhibiteurs de protéase du VIH.
- effets indésirables : Inhibiteurs de la transcriptase inverse, Inhibiteurs de protéase du VIH, Lopinavir, Pyrrolidones, Ritonavir.
- imagerie diagnostique : Fémur, Vertèbres lombales.
- traitement médicamenteux : Infections à VIH.
- épidémiologie : Argentine, Inde, Maladies osseuses métaboliques, Malaisie, Ostéoporose, République d'Afrique du Sud, Thaïlande.
- Pascal (Inist)
- Absorptiométrie photonique, Adulte, Densité osseuse, Facteurs de risque, Femelle, Humains, Infections à VIH, Maladies osseuses métaboliques, Mâle, Ostéoporose, Prévalence, Raltégravir de potassium, Résultat thérapeutique, SIDA, Raltégravir, Lopinavir, Ritonavir, Densité minérale osseuse, Etude comparative, Norme, Virus immunodéficience humaine, Traitement, Antirétroviral, Antiviral, Chimiothérapie, Ténofovir.
- Wicri :
- topic : Norme.
English descriptors
- KwdEn :
- AIDS, Absorptiometry, Photon, Adult, Antiretroviral agent, Antiviral, Argentina (epidemiology), Bone Density (drug effects), Bone Diseases, Metabolic (complications), Bone Diseases, Metabolic (epidemiology), Bone mineral density, Chemotherapy, Comparative study, Female, Femur (diagnostic imaging), HIV Infections (complications), HIV Infections (drug therapy), HIV Protease Inhibitors (administration & dosage), HIV Protease Inhibitors (adverse effects), Human immunodeficiency virus, Humans, India (epidemiology), Lopinavir, Lopinavir (adverse effects), Lumbar Vertebrae (diagnostic imaging), Malaysia (epidemiology), Male, Osteoporosis (complications), Osteoporosis (epidemiology), Prevalence, Pyrrolidinones (adverse effects), Raltegravir, Raltegravir Potassium, Reverse Transcriptase Inhibitors (administration & dosage), Reverse Transcriptase Inhibitors (adverse effects), Risk Factors, Ritonavir, Ritonavir (adverse effects), South Africa (epidemiology), Standards, Tenofovir, Thailand (epidemiology), Treatment, Treatment Outcome.
- MESH :
- chemical , administration & dosage : HIV Protease Inhibitors, Reverse Transcriptase Inhibitors.
- chemical , adverse effects : HIV Protease Inhibitors, Lopinavir, Pyrrolidinones, Reverse Transcriptase Inhibitors, Ritonavir.
- complications : Bone Diseases, Metabolic, HIV Infections, Osteoporosis.
- diagnostic imaging : Femur, Lumbar Vertebrae.
- drug effects : Bone Density.
- drug therapy : HIV Infections.
- epidemiology : Argentina, Bone Diseases, Metabolic, India, Malaysia, Osteoporosis, South Africa, Thailand.
- Absorptiometry, Photon, Adult, Female, Humans, Male, Prevalence, Raltegravir Potassium, Risk Factors, Treatment Outcome.
Abstract
Objective: To compare changes over 48 weeks in bone mineral density (BMD) between participants randomized to lopinavir/ritonavir (LPV/r) + raltegravir (RAL) or LPV/r + 2-3 nucleoside/nucleotide reverse transcriptase inhibitors (N(t)RTIs) as second line therapy. Design: 48-week open-label sub-study of the Second Line trial conducted in South Africa, India, Thailand, Malaysia and Argentina. Methods: Dual energy X-ray absorptiometry scans of proximal femur and lumbar spine were performed at baseline and week 48. Linear regression was used to compare means of differences between arms. McNemars test compared osteopenia and osteoporosis. Associations between percentage BMD changes and baseline variables were assessed by multivariate linear regression. Results: Two hundred and ten participants were randomized. Analyses were adjusted for sex, BMI and smoking status. Mean (95% CI) proximal femur BMD% reduced over 48 weeks by -5.2% (-6.7 to -3.8%) in the LPV/r+2-3N(t)RTIs arm and by -2.9% (-4.3 to -1.5%) in the LPV/r+RAL arm (P=0.0001). Lumbar spine BMD reduced by -4.2% (-5.7 to -2.7%) in the LPV/r+2-3N(t)RTIs arm and by -2.0% (-3.5 to -0.6%) in the LPV/r+RAL arm (P=0.0006). The incidence of osteopenia (7.6%) and osteoporosis (2.0%) assessed over 48 weeks were similar between arms. Reduced BMD over 48 weeks was significantly associated with longer duration of tenofovir on study [% change (SE) -1.58 (0.38) femur, -1.65 (0.38) spine, P=0.0001] and low baseline BMI [% change (SE) 0.5 (0.13) femur, 0.17 (0.07) spine; P<0.01]. Conclusion: An N(t)RTI-sparing antiretroviral regimen of LPV/r and raltegravir as second line therapy is associated with less bone loss than a LPV/r regimen containing N(t)RTIs.
Url:
Affiliations:
- Argentine, Australie, France, Irlande (pays), Thaïlande
- Nouvelle-Galles du Sud, Victoria (État), Île-de-France
- Melbourne, Paris, Sydney
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Le document en format XML
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G." last="Mallon">Patrick W. G. Mallon</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>UCD School of Medicine and Medical Science</s1><s2>Dublin</s2><s3>IRL</s3><sZ>3 aut.</sZ></inist:fA14><country>Irlande (pays)</country><wicri:noRegion>UCD School of Medicine and Medical Science</wicri:noRegion></affiliation></author><author><name sortKey="Hoy, Jennifer" sort="Hoy, Jennifer" uniqKey="Hoy J" first="Jennifer" last="Hoy">Jennifer Hoy</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>The Alfred Hospital</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>4 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Emery, Sean" sort="Emery, Sean" uniqKey="Emery S" first="Sean" last="Emery">Sean Emery</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>The Kirby Institute, University of New South Wales</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Belloso, Waldo" sort="Belloso, Waldo" uniqKey="Belloso W" first="Waldo" last="Belloso">Waldo Belloso</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>CICAL</s1><s2>Buenos Aires</s2><s3>ARG</s3><sZ>6 aut.</sZ></inist:fA14><country>Argentine</country><wicri:noRegion>CICAL</wicri:noRegion></affiliation></author><author><name sortKey="Phanuphak, Praphan" sort="Phanuphak, Praphan" uniqKey="Phanuphak P" first="Praphan" last="Phanuphak">Praphan Phanuphak</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Thai Red Cross AIDS Research Center</s1><s2>Bangkok</s2><s3>THA</s3><sZ>7 aut.</sZ></inist:fA14><country>Thaïlande</country><wicri:noRegion>Thai Red Cross AIDS Research Center</wicri:noRegion></affiliation></author><author><name sortKey="Ferret, Samuel" sort="Ferret, Samuel" uniqKey="Ferret S" first="Samuel" last="Ferret">Samuel Ferret</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Hopital Saint-Louis</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Cooper, David A" sort="Cooper, David A" uniqKey="Cooper D" first="David A." last="Cooper">David A. Cooper</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>The Kirby Institute, University of New South Wales</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Boyd, Mark A" sort="Boyd, Mark A" uniqKey="Boyd M" first="Mark A." last="Boyd">Mark A. Boyd</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>The Kirby Institute, University of New South Wales</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author></analytic><series><title level="j" type="main">AIDS : (London)</title><title level="j" type="abbreviated">AIDS : (Lond.)</title><idno type="ISSN">0269-9370</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">AIDS : (London)</title><title level="j" type="abbreviated">AIDS : (Lond.)</title><idno type="ISSN">0269-9370</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term><term>Absorptiometry, Photon</term><term>Adult</term><term>Antiretroviral agent</term><term>Antiviral</term><term>Argentina (epidemiology)</term><term>Bone Density (drug effects)</term><term>Bone Diseases, Metabolic (complications)</term><term>Bone Diseases, Metabolic (epidemiology)</term><term>Bone mineral density</term><term>Chemotherapy</term><term>Comparative study</term><term>Female</term><term>Femur (diagnostic imaging)</term><term>HIV Infections (complications)</term><term>HIV Infections (drug therapy)</term><term>HIV Protease Inhibitors (administration & dosage)</term><term>HIV Protease Inhibitors (adverse effects)</term><term>Human immunodeficiency virus</term><term>Humans</term><term>India (epidemiology)</term><term>Lopinavir</term><term>Lopinavir (adverse effects)</term><term>Lumbar Vertebrae (diagnostic imaging)</term><term>Malaysia (epidemiology)</term><term>Male</term><term>Osteoporosis (complications)</term><term>Osteoporosis (epidemiology)</term><term>Prevalence</term><term>Pyrrolidinones (adverse effects)</term><term>Raltegravir</term><term>Raltegravir Potassium</term><term>Reverse Transcriptase Inhibitors (administration & dosage)</term><term>Reverse Transcriptase Inhibitors (adverse effects)</term><term>Risk Factors</term><term>Ritonavir</term><term>Ritonavir (adverse effects)</term><term>South Africa (epidemiology)</term><term>Standards</term><term>Tenofovir</term><term>Thailand (epidemiology)</term><term>Treatment</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Absorptiométrie photonique</term><term>Adulte</term><term>Argentine (épidémiologie)</term><term>Densité osseuse ()</term><term>Facteurs de risque</term><term>Femelle</term><term>Fémur (imagerie diagnostique)</term><term>Humains</term><term>Inde (épidémiologie)</term><term>Infections à VIH ()</term><term>Infections à VIH (traitement médicamenteux)</term><term>Inhibiteurs de la transcriptase inverse (administration et posologie)</term><term>Inhibiteurs de la transcriptase inverse (effets indésirables)</term><term>Inhibiteurs de protéase du VIH (administration et posologie)</term><term>Inhibiteurs de protéase du VIH (effets indésirables)</term><term>Lopinavir (effets indésirables)</term><term>Maladies osseuses métaboliques ()</term><term>Maladies osseuses métaboliques (épidémiologie)</term><term>Malaisie (épidémiologie)</term><term>Mâle</term><term>Ostéoporose ()</term><term>Ostéoporose (épidémiologie)</term><term>Prévalence</term><term>Pyrrolidones (effets indésirables)</term><term>Raltégravir de potassium</term><term>Ritonavir (effets indésirables)</term><term>République d'Afrique du Sud (épidémiologie)</term><term>Résultat thérapeutique</term><term>Thaïlande (épidémiologie)</term><term>Vertèbres lombales (imagerie diagnostique)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>HIV Protease Inhibitors</term><term>Reverse Transcriptase Inhibitors</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>HIV Protease Inhibitors</term><term>Lopinavir</term><term>Pyrrolidinones</term><term>Reverse Transcriptase Inhibitors</term><term>Ritonavir</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Inhibiteurs de la transcriptase inverse</term><term>Inhibiteurs de protéase du VIH</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Bone Diseases, Metabolic</term><term>HIV Infections</term><term>Osteoporosis</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Femur</term><term>Lumbar Vertebrae</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Bone Density</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Inhibiteurs de la transcriptase inverse</term><term>Inhibiteurs de protéase du VIH</term><term>Lopinavir</term><term>Pyrrolidones</term><term>Ritonavir</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Argentina</term><term>Bone Diseases, Metabolic</term><term>India</term><term>Malaysia</term><term>Osteoporosis</term><term>South Africa</term><term>Thailand</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Fémur</term><term>Vertèbres lombales</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Argentine</term><term>Inde</term><term>Maladies osseuses métaboliques</term><term>Malaisie</term><term>Ostéoporose</term><term>République d'Afrique du Sud</term><term>Thaïlande</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Absorptiometry, Photon</term><term>Adult</term><term>Female</term><term>Humans</term><term>Male</term><term>Prevalence</term><term>Raltegravir Potassium</term><term>Risk Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Absorptiométrie photonique</term><term>Adulte</term><term>Densité osseuse</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Infections à VIH</term><term>Maladies osseuses métaboliques</term><term>Mâle</term><term>Ostéoporose</term><term>Prévalence</term><term>Raltégravir de potassium</term><term>Résultat thérapeutique</term><term>SIDA</term><term>Raltégravir</term><term>Lopinavir</term><term>Ritonavir</term><term>Densité minérale osseuse</term><term>Etude comparative</term><term>Norme</term><term>Virus immunodéficience humaine</term><term>Traitement</term><term>Antirétroviral</term><term>Antiviral</term><term>Chimiothérapie</term><term>Ténofovir</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Norme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: To compare changes over 48 weeks in bone mineral density (BMD) between participants randomized to lopinavir/ritonavir (LPV/r) + raltegravir (RAL) or LPV/r + 2-3 nucleoside/nucleotide reverse transcriptase inhibitors (N(t)RTIs) as second line therapy. Design: 48-week open-label sub-study of the Second Line trial conducted in South Africa, India, Thailand, Malaysia and Argentina. Methods: Dual energy X-ray absorptiometry scans of proximal femur and lumbar spine were performed at baseline and week 48. Linear regression was used to compare means of differences between arms. McNemars test compared osteopenia and osteoporosis. Associations between percentage BMD changes and baseline variables were assessed by multivariate linear regression. Results: Two hundred and ten participants were randomized. Analyses were adjusted for sex, BMI and smoking status. Mean (95% CI) proximal femur BMD% reduced over 48 weeks by -5.2% (-6.7 to -3.8%) in the LPV/r+2-3N(t)RTIs arm and by -2.9% (-4.3 to -1.5%) in the LPV/r+RAL arm (P=0.0001). Lumbar spine BMD reduced by -4.2% (-5.7 to -2.7%) in the LPV/r+2-3N(t)RTIs arm and by -2.0% (-3.5 to -0.6%) in the LPV/r+RAL arm (P=0.0006). The incidence of osteopenia (7.6%) and osteoporosis (2.0%) assessed over 48 weeks were similar between arms. Reduced BMD over 48 weeks was significantly associated with longer duration of tenofovir on study [% change (SE) -1.58 (0.38) femur, -1.65 (0.38) spine, P=0.0001] and low baseline BMI [% change (SE) 0.5 (0.13) femur, 0.17 (0.07) spine; P<0.01]. Conclusion: An N(t)RTI-sparing antiretroviral regimen of LPV/r and raltegravir as second line therapy is associated with less bone loss than a LPV/r regimen containing N(t)RTIs.</div></front></TEI><affiliations><list><country><li>Argentine</li><li>Australie</li><li>France</li><li>Irlande (pays)</li><li>Thaïlande</li></country><region><li>Nouvelle-Galles du Sud</li><li>Victoria (État)</li><li>Île-de-France</li></region><settlement><li>Melbourne</li><li>Paris</li><li>Sydney</li></settlement></list><tree><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Martin, Allison" sort="Martin, Allison" uniqKey="Martin A" first="Allison" last="Martin">Allison Martin</name></region><name sortKey="Boyd, Mark A" sort="Boyd, Mark A" uniqKey="Boyd M" first="Mark A." last="Boyd">Mark A. Boyd</name><name sortKey="Cooper, David A" sort="Cooper, David A" uniqKey="Cooper D" first="David A." last="Cooper">David A. Cooper</name><name sortKey="Emery, Sean" sort="Emery, Sean" uniqKey="Emery S" first="Sean" last="Emery">Sean Emery</name><name sortKey="Hoy, Jennifer" sort="Hoy, Jennifer" uniqKey="Hoy J" first="Jennifer" last="Hoy">Jennifer Hoy</name><name sortKey="Moore, Cecilia" sort="Moore, Cecilia" uniqKey="Moore C" first="Cecilia" last="Moore">Cecilia Moore</name></country><country name="Irlande (pays)"><noRegion><name sortKey="Mallon, Patrick W G" sort="Mallon, Patrick W G" uniqKey="Mallon P" first="Patrick W. G." last="Mallon">Patrick W. G. Mallon</name></noRegion></country><country name="Argentine"><noRegion><name sortKey="Belloso, Waldo" sort="Belloso, Waldo" uniqKey="Belloso W" first="Waldo" last="Belloso">Waldo Belloso</name></noRegion></country><country name="Thaïlande"><noRegion><name sortKey="Phanuphak, Praphan" sort="Phanuphak, Praphan" uniqKey="Phanuphak P" first="Praphan" last="Phanuphak">Praphan Phanuphak</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Ferret, Samuel" sort="Ferret, Samuel" uniqKey="Ferret S" first="Samuel" last="Ferret">Samuel Ferret</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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