No evidence of pitavastatin effect on muscle area or density among people with HIV.
Skeletal muscle area (MA) and muscle density (MD) are key determinants of physical function and typically decline with increasing age. Statins have well-known musculoskeletal effects but whether statins impact MA or MD is not well established, especially in the setting of randomized treatment.
REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events in people with HIV (PWH). Thoracic paraspinal, pectoralis, and infraspinatus MA and MD were assessed among Mechanistic Substudy participants with CT at baseline and month 24.
Of 804 substudy participants, 510 remained on study treatment and had imaging at baseline and month 24. Median age was 51 years; 17% were natal female, 35% Black, and 27% Hispanic. There were no apparent changes in muscle measures from baseline to month 24 within the treatment groups. The estimated treatment group differences in baseline-adjusted month 24 outcomes were minimal (within 0.5 cm2/m for height-adjusted MA with 95% CI bounds within <1 cm2/m, and within 1 Hounsfield units (HU) for MD with 95% CI bounds within <3 HU; all p > 0.2). Findings were generally consistent in subgroup analyses.
Pitavastatin was associated with no apparent change in muscle measures over 24 months, and with no evidence of detrimental effect among PWH.
REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events in people with HIV (PWH). Thoracic paraspinal, pectoralis, and infraspinatus MA and MD were assessed among Mechanistic Substudy participants with CT at baseline and month 24.
Of 804 substudy participants, 510 remained on study treatment and had imaging at baseline and month 24. Median age was 51 years; 17% were natal female, 35% Black, and 27% Hispanic. There were no apparent changes in muscle measures from baseline to month 24 within the treatment groups. The estimated treatment group differences in baseline-adjusted month 24 outcomes were minimal (within 0.5 cm2/m for height-adjusted MA with 95% CI bounds within <1 cm2/m, and within 1 Hounsfield units (HU) for MD with 95% CI bounds within <3 HU; all p > 0.2). Findings were generally consistent in subgroup analyses.
Pitavastatin was associated with no apparent change in muscle measures over 24 months, and with no evidence of detrimental effect among PWH.
Authors
Erlandson Erlandson, Umbleja Umbleja, Ribaudo Ribaudo, Lu Lu, Taron Taron, Diggs Diggs, Douglas Douglas, Fitch Fitch, Fichtenbaum Fichtenbaum, Zanni Zanni, Aberg Aberg, Rodriguez-Barradas Rodriguez-Barradas, Breaux Breaux, Morones Morones, Sponseller Sponseller, Currier Currier, Bloomfield Bloomfield, Chu Chu, Lu Lu, Malvestutto Malvestutto, Grinspoon Grinspoon, Brown Brown
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