{"id":19821,"date":"2012-08-01T12:23:12","date_gmt":"2012-08-01T12:23:12","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=19821"},"modified":"2012-08-16T16:37:28","modified_gmt":"2012-08-16T16:37:28","slug":"skeletal-muscle-toxicity-and-raltegravir","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/19821","title":{"rendered":"Skeletal muscle toxicity and raltegravir"},"content":{"rendered":"<p><strong>Simon Collins, HIV i-Base<\/strong><\/p>\n<p><strong>An Australian study reported higher rates of muscle toxicity associated with raltegravir in asymtomatic patients.<\/strong><\/p>\n<p>Prompted by higher rates of grade 3\/4 creatinine kinase (CK) in registrational studies for raltegravir, and rare cases of rhabdomyolysis, Frederick Lee from St Vincent&#8217;s, Sydney and colleagues looked at differences in muscle toxicity in 318 HIV positive patients, half who were using raltegravir and half on non-raltegravir combinations.<\/p>\n<p>Muscle toxicity was categorised in four ways: isolated CK elevation, myalgia without muscle weakness, proximal myopathy on examination, or rhabdomyolysis.<\/p>\n<p>Characteristics of the group included: male (98%), white (89%), median age 51 years, median CD4 count 585 cells\/mm3 with 91% undetectable (&lt;50 copies\/mL). Raltegravir has been used for a mean duration of 28 months. Recent vigorous exercise was reported by 42% and statins by 24%.<\/p>\n<p>A higher proportion of patients on raltegravir reported at least one feature of muscle toxicity (37% vs 19%, p &lt;0.01). Results by category were: CK elevation 14% vs 16% (NS), mylagia without weakness 19% vs 3%, p&lt; 0.01 and proximal myopathy 4% vs 0, p=0.03, all raltgravir vs non-raltegravir respectively. No cases of rhabdomyolysis were seen.<\/p>\n<p>Most CK elevations were grade 1 with the single grade 3\/4 occurring in the non-raltegravir arm.<\/p>\n<p>In multivariate analysis, only raltegravir use (OR 2.64; 95%CI: 1.57-4.45, p&lt;0.01) and recent exercise (OR 2.26; 95%CI: 1.36-3.77, p&lt;0.01) were independently associated with skeletal muscle toxicity. However, neither raltegravir drug levels nor duration of use were associated with any parameter.<\/p>\n<p>Reference:<\/p>\n<p>Lee FJ et al. Skeletal muscle toxicity associated with raltegravir-based combination antiretroviral therapy in HIV-infected adults. 14th IWCADR, 19-21 July 2012, Washington. Oral abstract 015. Antiviral therapy 2012; 17 Suppl 2:A13.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base An Australian study reported higher rates of muscle toxicity associated with raltegravir in asymtomatic patients. Prompted by higher rates of grade 3\/4 creatinine kinase (CK) in registrational studies for raltegravir, and rare cases of rhabdomyolysis, Frederick &hellip;<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,3,8],"tags":[160],"class_list":["post-19821","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-antiretrovirals","category-side-effects","tag-lipo-14th-2012"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/19821","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=19821"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/19821\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=19821"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=19821"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=19821"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}