To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Patients at High Risk of Heart Disease Fare Poorly While Taking Abacavir or Didanosine: Presented at CROI URL: http://www.pslgroup.com/dg/21C946.htm Doctor's Guide February 6, 2008
By Ed Susman BOSTON, MA -- February 6, 2008 -- In high-risk individuals the nucleoside reverse transcriptase inhibitors abacavir and didanosine are associated with increased risk of myocardial infarction, according to research presented here at the 15th Conference on Retroviruses and Opportunistic Infections (CROI). "Abacavir use was associated with a 90% increased risk of getting a heart attack, and the risk of a heart attack with the use of didanosine was increased by 49%," said Jens Lundgren, MD, Professor of Infectious Disease Epidemiology, University of Copenhagen, and Director, Copenhagen HIV Programme, Copenhagen, Denmark. In a poster presentation on February 4, Dr. Lundgren reported on his team's analysis of the Data Collection of Adverse Effects of Anti-HIV Drugs (D:A:D) study. D:A:D is a collaboration of 11 prospective cohorts; it includes data on 33,347 patients. A total of 517 patients developed a myocardial infarction during 157,912 person-years. Dr. Lundgren and colleagues assessed the effect of cumulative, recent, and past use of the thymidine analogs abacavir, didanosine, and lamivudine after adjusting for demographics, known cardiovascular risk factors, cohort, calendar year, body mass index, and use of other antiretroviral agents. Because thymidine analogs have previously been associated with risk of dyslipidemia, the researchers expected to find a link between their use and development of cardiovascular disease, Dr. Lundgren said. "Contrary to our hypothesis, use of thymidine analogs was not associated with the risk of a myocardial infarction," he said. "The data showed that the effect from abacavir and didanosine on increased risk of heart attack was observed only while patients were receiving the drugs, but not in patients who had previously used them but had stopped for more than 6 months," Dr. Lundgren said. "This finding suggests that the drug effect is reversible upon cessation of the drugs. There is no evidence to suggest that duration of exposure to either drug increased the risk of heart attack." The analysis indicated that patients with moderate heart disease risks at baseline who were on antiretroviral therapy had a 10-year risk of myocardial infarction that was 119% greater than HIV patients without heart attack risks at baseline (P =.0001). Patients taking antiretrovirals who were at high risk of heart disease at baseline had a 222% increased 10-year risk of a heart attack (P =.0001). The significant risk of taking abacavir (P =.0001) and didanosine (P =.005) remained after considering variables such as viral load, CD4-positive cell count, dyslipidemia, and other metabolic disorders. The D:A:D study is funded by the HAART Oversight Committee, an initiative of the European Medicines Evaluation Agency, and is supported through grants from Abbott Laboratories, AIDS Treatment Action Coalition, Boehringer-Ingelheim Pharmaceuticals Inc., Bristol-Myers Squibb, European AIDS Treatment Group, US Food and Drug Administration, F. Hoffmann-La Roche Ltd., Gilead Sciences, Inc., GlaxoSmithKline, Merck & Co. Inc., and Pfizer Inc. [Presentation title: Do Thymidine Analogues, Abacavir, Didanosine and Lamivudine Contribute to the Risk of Myocardial Infarction? The D:A:D Study. Abstract 957c] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.