Bone mineral density in HIV participants randomized to raltegravir and lopinavir/ritonavir compared with standard second line therapy

Allison Martin, Cecilia L Moore, Patrick Mallon, Jennifer F Hoy, Sean Emery, Waldo H Belloso, Praphan Phanuphak, Samuel Ferret, David A Cooper, Mark Boyd

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26 Citations (Scopus)

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
Original languageEnglish
Pages (from-to)2403 - 2411
Number of pages9
JournalAIDS
Volume27
Issue number15
DOIs
Publication statusPublished - 2013

Cite this

Martin, Allison ; Moore, Cecilia L ; Mallon, Patrick ; Hoy, Jennifer F ; Emery, Sean ; Belloso, Waldo H ; Phanuphak, Praphan ; Ferret, Samuel ; Cooper, David A ; Boyd, Mark. / Bone mineral density in HIV participants randomized to raltegravir and lopinavir/ritonavir compared with standard second line therapy. In: AIDS. 2013 ; Vol. 27, No. 15. pp. 2403 - 2411.
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title = "Bone mineral density in HIV participants randomized to raltegravir and lopinavir/ritonavir compared with standard second line therapy",
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",
author = "Allison Martin and Moore, {Cecilia L} and Patrick Mallon and Hoy, {Jennifer F} and Sean Emery and Belloso, {Waldo H} and Praphan Phanuphak and Samuel Ferret and Cooper, {David A} and Mark Boyd",
year = "2013",
doi = "10.1097/01.aids.0000432534.47217.b4",
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Martin, A, Moore, CL, Mallon, P, Hoy, JF, Emery, S, Belloso, WH, Phanuphak, P, Ferret, S, Cooper, DA & Boyd, M 2013, 'Bone mineral density in HIV participants randomized to raltegravir and lopinavir/ritonavir compared with standard second line therapy', AIDS, vol. 27, no. 15, pp. 2403 - 2411. https://doi.org/10.1097/01.aids.0000432534.47217.b4

Bone mineral density in HIV participants randomized to raltegravir and lopinavir/ritonavir compared with standard second line therapy. / Martin, Allison; Moore, Cecilia L; Mallon, Patrick; Hoy, Jennifer F; Emery, Sean; Belloso, Waldo H; Phanuphak, Praphan; Ferret, Samuel; Cooper, David A; Boyd, Mark.

In: AIDS, Vol. 27, No. 15, 2013, p. 2403 - 2411.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Bone mineral density in HIV participants randomized to raltegravir and lopinavir/ritonavir compared with standard second line therapy

AU - Martin, Allison

AU - Moore, Cecilia L

AU - Mallon, Patrick

AU - Hoy, Jennifer F

AU - Emery, Sean

AU - Belloso, Waldo H

AU - Phanuphak, Praphan

AU - Ferret, Samuel

AU - Cooper, David A

AU - Boyd, Mark

PY - 2013

Y1 - 2013

N2 - 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

AB - 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

UR - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815006/pdf/aids-27-2403.pdf

U2 - 10.1097/01.aids.0000432534.47217.b4

DO - 10.1097/01.aids.0000432534.47217.b4

M3 - Article

VL - 27

SP - 2403

EP - 2411

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 15

ER -