(Reuters Health) - Acipimox, a nicotinic acid analog and potent inhibitor of lipolysis, improves triglycerides and insulin sensitivity in HIV-infected patients with metabolic disturbances, report clinicians from Massachusetts General Hospital and Harvard Medical School, Boston.
In the November issue of the Journal of Clinical Endocrinology and Metabolism, Dr. Colleen Hadigan and colleagues note that "one potentially contributing factor to dyslipidemia in HIV-infected patients with lipodystrophy may be inappropriately elevated rates of lipolysis and increased circulating free fatty acids."
They evaluated the efficacy and safety of chronic inhibition of lipolysis with acipimox in 23 HIV-infected men and women with hypertriglyceridemia and abnormal fat distribution who were not on lipid-lowering therapy. For 3 months, 11 subjects took acipimox (250 mg t.i.d.) and 12 took placebo.
According to the team, acipimox was associated with significant suppression of lipolysis and a 68% reduction in circulating free fatty acids. This was accompanied by a significant but modest triglyceride reduction of 48 mg/dL (median) and significant improvements in insulin sensitivity.
These metabolic improvements were not seen with placebo.
"Hypertriglyceridemia and insulin resistance are frequently recognized in HIV-infected patients and confer significant increased risk of metabolic syndrome, diabetes, and cardiovascular disease," Dr. Hadigan and colleagues note.
"Improvement in overall metabolic profile with acipimox suggests a potential clinical utility for this agent that requires further investigation," they conclude.
Acipimox, they also point out, is "an established available therapy for dyslipidemia outside the United States, with known efficacy in familial hypercholesterolemia and in association with type 2 diabetes."
If you don't understand one of the words in this article,
just double-click it. A window will open with a definition
from CancerWEB's On-line Medical Dictionary. If the double-click feature
doesn't work in your browser, you can enter the word below:
