REPRIEVE
Trial question
What is the role of pitavastatin in patients with HIV infection at risk of CVD?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
31.0% female
69.0% male
N = 7769
7769 patients (2419 female, 5350 male).
Inclusion criteria: patients with HIV infection with a low-to-moderate risk of CVD who were receiving antiretroviral therapy.
Key exclusion criteria: history of statin use within the previous 90 days; known ASCVD.
Interventions
N=3888 pitavastatin (at a dose of 4 mg daily).
N=3881 placebo (matching placebo daily).
Primary outcome
Incidence of major adverse cardiovascular event
4.81
7.32
7.3/1000 py
5.5/1000 py
3.7/1000 py
1.8/1000 py
0.0/1000 py
Pitavastatin
Placebo
Significant
decrease ▼
Significant decrease in the incidence of major adverse cardiovascular event (4.81/1000 py vs. 7.32/1000 py; HR 0.65, 95% CI 0.48 to 0.9).
Secondary outcomes
Significant decrease in the incidence of major adverse cardiovascular event or death (9.18/1000 py vs. 11.63/1000 py; HR 0.79, 95% CI 0.65 to 0.96).
No significant difference in the incidence of death from any cause (6.17/1000 py vs. 6.83/1000 py; HR 0.9, 95% CI 0.7 to 1.16).
Significant decrease in the incidence of first cardiac ischemia or MI (1.4/1000 py vs. 2.51/1000 py; HR 0.56, 95% CI 0.34 to 0.9).
Safety outcomes
No significant differences in adverse event, nonfatal serious adverse events.
Conclusion
In patients with HIV infection with a low-to-moderate risk of CVD who were receiving antiretroviral therapy, pitavastatin was superior to placebo with respect to the incidence of major adverse cardiovascular event.
Reference
Steven K Grinspoon, Kathleen V Fitch, Markella V Zanni et al. Pitavastatin to Prevent Cardiovascular Disease in HIV Infection. N Engl J Med. 2023 Aug 24;389(8):687-699.
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