TORONTO, Sept. 14 /PRNewswire/ -- Physicians who treat people living with
HIV are less conclusive about the causes of lipodystrophy, a condition that
affects some people living with HIV. Seventy-one percent of physicians
believe that the causes of lipodystrophy are multifactorial, compared to
53% who recalled believing that it was multi-factorial two years ago.
Lipodystrophy is a condition characterized by abnormal distribution of fat,
which may include an increase in abdominal girth, fat accumulation behind the
neck (known as buffalo hump), and/or lipoatrophy (the loss of fat in the face
and limbs). The survey results were released in conjunction with the 2nd
International Workshop on Adverse Drug Reactions and Lipdodystrophy in HIV.
The survey comprised 300 physicians who had written at least twenty-two
prescriptions for HIV medications in the past month and who treat an average
of 130 patients. Half of the physicians surveyed were board certified in
infectious disease and half were primary care physicians. Physicians
estimated that approximately one in five of their patients experienced
lipodystrophy.
Perceptions of the causes of lipodystrophy have evolved with the advent of
new research. Less than two-thirds of physicians now indicate that protease
inhibitors are one of the causes, a decrease from nearly three-fourths two
years ago. When asked about the contribution of nucleoside analogs, 70% of
infectious disease specialists believe that nucleoside analogs contribute to
lipodystrophy.
Responding physicians identified the following other factors as likely
contributors to lipodystrophy: the use of non-nucleoside reverse transcriptase
inhibitors (NNRTIs, 27%), use of nucleoside analogs (33%), the length of HIV
infection (35%), and the time on antiviral therapy (44%).
Evidence of Lipodystrophy in Patients Not Taking Protease Inhibitors
Results further confirm the observation that HIV infection itself may be a
factor in lipodystrophy. Among responding physicians who have patients never
exposed to protease inhibitors, 40% reported that their protease
inhibitor-naive patients showed evidence of lipodystrophy. Of physicians with
patients who had not received any antiretroviral treatment, one in ten had
patients who showed evidence of the condition.
Lipodystrophy Subjectively Defined
While physicians have a general understanding of lipodystrophy, no
consensus exists on clinical measures used to define lipodystrophy. When
questioned, the vast majority of physicians (92%) define lipodystrophy as
"maldistribution of body fat", "buffalo hump", "thinning of arms and legs",
"facial thinning", and/or "increases in abdomen size." Few physicians
mentioned metabolic markers when defining lipodystrophy, including only
14% who mentioned lipid abnormalities, 7% who specifically mentioned changes
in cholesterol levels, 3% who mentioned diabetes and 2% of respondents who
mentioned increases in triglycerides.
Links to Therapy
More than half of the physicians surveyed observed a link between a
specific HIV therapy and lipodystrophy. The medications mentioned were
Crixivan(R) (indinavir) by 31% of respondents, Norvir(R) (ritonavir) by 20%,
Zerit(R) (d4T/stavudine) by 18%, Viracept(R) (nelfinavir) by 8%,
Fortovase/Invirase(R) (saquinavir) by 5%, Videx(R) (didanosine) by 3% and
Retrovir(R) (AZT/zidovudine) by 3%.
Future Lipodystrophy Research
Most physicians surveyed support the need for additional prospective
clinical trials to more clearly define lipodystrophy and its causes. Over
two-thirds of physicians suggested controlled trials comparing therapies
within a class (i.e., NNRTIs, nucleoside analogues, protease inhibitors),
across classes, and with HIV positive patients who are not receiving therapy.
Physicians also suggested other types of studies, including analyzing the fat
in a person's body, gene studies, metabolic studies, and the use of insulin
sensitizers.
This telephone-administered survey was conducted by Roper Starch Worldwide
during August 2000. The survey sample was obtained from National Data
Corporation Health Information Services, which tracks prescriptions from
terminals at 34,000 pharmacies nationwide. The data collected at the terminal
is cross-referenced to the American Medical Association database to provide
descriptive information on every physician, including name, telephone number,
and specialty.
The survey was sponsored by Agouron Pharmaceuticals, Inc. Agouron
Pharmaceuticals, Inc., a Pfizer Company (NYSE: PFE), is committed to the
discovery, development, and marketing of innovative therapeutic products
engineered to inactivate proteins that play key roles in cancer, AIDS, and
other serious diseases. Agouron employs more than 1400 people of whom
approximately 850 are engaged in research and development.
Pfizer Inc, the world's largest pharmaceutical company, discovers,
develops, manufactures and markets leading prescription medicines, for humans
and animals, and many of the world's best known over-the-counter brands. This
year, Pfizer expects global sales of more than $30 billion and has a research
and development budget of $4.7 billion.
SOURCE Agouron Pharmaceuticals, Inc
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CONTACT:
Joy Schmitt of Agouron Pharmaceuticals, Inc.,
858-622-3220
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