Comparative Effectiveness and Safety of Lipid Lowering Agents for the Treatment of Dyslipidemia in HIV-Positive Individuals

Abstract

As the HIV-positive population ages, managing non-AIDS-related comorbidities such as cardiovascular disease (CVD) complicates HIV care. Effectively treating risk factors for CVD will help reduce its burden in the HIV-infected population. However, the evidence base for the efficacy of statins as lipid-lowering therapies in HIV-infected patients has yet to be synthesized. Most trials do not compare statins directly to each other. In the absence of head-to-head evidence, the relative treatment effects of different statins can be indirectly obtained through a network meta-analysis (NMA). This NMA aims to evaluate the use of statins for treating dyslipidemia in HIV-infected individuals. Bayesian methods were used for obtaining treatment effect estimates and probabilistic rankings of treatments. Among lipid-lowering therapies, statins were most effective in treating dyslipidemia. All statins were found to offer the same treatment benefits. To our knowledge, this is the first NMA on this topic. It provides clinicians, health economists, and policy decision-makers with precise and reliable estimates for making definitive recommendations for the use of statins in dyslipidemic HIV-positive patients.