Atorvastatin on Biomarkers of Inflammation, Coagulopathy, Angiogenesis & T-cells

Sponsor
AIDS Clinical Trials Group (Other)
Overall Status
Completed
CT.gov ID
NCT01351025
Collaborator
National Institute of Allergy and Infectious Diseases (NIAID) (NIH), Pfizer (Industry)
98
31
2
36.6
3.2
0.1

Study Details

Study Description

Brief Summary

ACTG A5275 was a prospective, double-blind, randomized, placebo-controlled cross-over design pilot study evaluating the effect of atorvastatin on biomarkers of inflammation, coagulopathy, angiogenesis, and T-lymphocyte activation in HIV-1 infected individuals with suppressed HIV-1 RNA on stable protease inhibitor based antiretroviral therapy with fasting LDL cholesterol < 130 mg/dL.

Atorvastatin is a drug approved by the Food and Drug Administration (FDA) for treating high cholesterol. Atorvastatin has also been able to lower the level of inflammation blood tests in certain other diseases but has not been studied for this purpose in people who have HIV. The main goal of this experimental study is to see how taking atorvastatin affects inflammation blood tests in people infected with HIV who do not need to take medicine for high cholesterol. In addition to observing the effects of atorvastatin on the level of inflammation measured in the blood, this study evaluated if atorvastatin is safe for people with HIV who are also taking medication for HIV.

Condition or Disease Intervention/Treatment Phase
Phase 2

Detailed Description

Since people started taking HIV medications, illness from AIDS has decreased, but other serious diseases like heart disease (heart attacks) and certain kinds of cancer have increased. HIV causes inflammation (irritation) inside the body that cannot be felt but can be measured by levels of certain inflammation blood tests. Inflammation may contribute to diseases (such as heart attacks) that have become some of the leading causes of death in people with HIV. HIV therapy can partially lower levels of inflammation measured in blood, however, levels of inflammation in people who have HIV who are taking certain kinds of anti-HIV drugs may remain high compared with those found in people not infected with HIV.

Study Design

Study Type:
Interventional
Actual Enrollment :
98 participants
Allocation:
Randomized
Intervention Model:
Crossover Assignment
Masking:
Triple (Participant, Care Provider, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
A Pilot Study Evaluating the Effect of Atorvastatin on Biomarkers of Inflammation, Coagulopathy, Angiogenesis, and T-lymphocyte Activation in HIV-1 Infected Individuals With Suppressed HIV-1 RNA and LDL Cholesterol < 130 mg/dL
Actual Study Start Date :
Apr 14, 2011
Actual Primary Completion Date :
May 1, 2014
Actual Study Completion Date :
May 1, 2014

Arms and Interventions

Arm Intervention/Treatment
Experimental: Arm A: atorvastatin / placebo

At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period.

Drug: atorvastatin
10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4- week 20
Other Names:
  • Lipitor
  • Drug: placebo for atorvastin
    One tablet once daily for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, then increase the dose to two tablets once daily.
    Other Names:
  • placebo
  • Experimental: Arm B: placebo / atorvastatin

    At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period.

    Drug: atorvastatin
    Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Other Names:
  • Lipitor
  • Drug: placebo for atorvastin
    One tablet once daily for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, then increase the dose to two tablets once daily.
    Other Names:
  • placebo
  • Outcome Measures

    Primary Outcome Measures

    1. Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in log10 IL-6 [baseline, week 20, week 24, and week 44]

      IL-6 (Interleukin 6) in log10 pg/mL: Difference between [change from week 24 to week 44] and [change from baseline to week 20] (i.e. [week 44 - week 24] - [week 20 - baseline])

    2. Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in CD4+ T-cell Activation Percent [baseline, week 20, week 24, and week 44]

      CD4+ T-cell activation percent (% CD38+/DR+ of CD4+): Difference between [change from week 24 to week 44] and [change from baseline to week 20] (i.e. [week 44 - week 24] - [week 20 - baseline])

    3. Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in log10 D-dimer [baseline, week 20, week 24, and week 44]

      D-dimer in log10 ng/mL: Difference between [change from week 24 to week 44] and [change from baseline to week 20] (i.e. [week 44 - week 24] - [week 20 - baseline])

    4. Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in CD8+ T-cell Activation Percent [baseline, week 20, week 24, and week 44]

      CD8+ T-cell activation percent (% CD38+/DR+ of CD8+): Difference between [change from week 24 to week 44] and [change from baseline to week 20] (i.e. [week 44 - week 24] - [week 20 - baseline])

    Secondary Outcome Measures

    1. Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in MCP-1 (log10 Transformed) [baseline, week 20, week 24, and week 44]

      Monocyte chemoattractant protein-1 (MCP-1/CCL2) is one of the key chemokines that regulate migration and infiltration of monocytes/macrophages. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].

    2. Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in IP-10 (log10 Transformed) [baseline, week 20, week 24, and week 44]

      IFN-gamma-inducible protein 10 (IP-10 or CXCL10) is a chemokine secreted from cells stimulated with type I and II IFNs and LPS, is also a chemoattractant for activated T cells. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].

    3. Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in CD40L (log10 Transformed) [baseline, week 20, week 24, and week 44]

      Cluster of differentiation 40 (CD40L) is a costimulatory protein found on antigen presenting cells and is required for their activation. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].

    4. Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in sCD14 (log10 Transformed) [baseline, week 20, week 24, and week 44]

      Soluble cluster of differentiation 14 (sCD14) is a human gene. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].

    5. Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in P-selectin (log10 Transformed) [baseline, week 20, week 24, and week 44]

      P-selectin is a protein that in humans encoded by the SELP gene. P-selectin functions as a cell adhesion molecule (CAM) on the surfaces of activated endothelial cells, which line the inner surface of blood vessels, and activated platelets. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].

    6. Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in sCD163 (log10 Transformed) [baseline, week 20, week 24, and week 44]

      CD163 (Cluster of Differentiation 163) is a protein that in humans encoded by the CD163 gene; and sCD163 is soluble CD163. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].

    7. Number of Participants With Safety Endpoints Before Study Treatment Cross-over (Baseline to Week 24) [week 0 to week 24]

      Safety endpoints are defined as grade ≥ 2 signs and symptoms, laboratory abnormalities, AST/ALT > 3 X ULN, and adverse events prior to study treatment cross-over (baseline to week 24). The DAIDS Adverse Event (AE) Grading Table, Version 1.0, December 2004 (Clarification, August 2009) was used for grading of AEs.

    8. Number of Participants With Safety Endpoints After Study Treatment Cross-over (Week 24 to Week 48) [week 24 to week 48]

      Safety endpoints are defined as grade ≥ 2 signs and symptoms, laboratory abnormalities, AST/ALT > 3 X ULN, and adverse events after study treatment cross-over (week 24 to week 48). The DAIDS Adverse Event (AE) Grading Table, Version 1.0, December 2004 (Clarification, August 2009) was used for grading of AEs.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • HIV-1 infected

    • Combination ART that includes any boosted PI regimen for at least 6 months prior to study entry

    • No plans to change the antiretroviral regimen in the next year

    • Must have been on the same HAART regimen for at least 12 weeks with no change prior to study entry. More information on this criterion can be found in the study protocol.

    • If on vitamin D replacement therapy, must have been on stable regimen for ≥ 1 mo. prior to study entry.

    • CD4+ T-cell count obtained within 45 days prior to study entry at any laboratory that has a Clinical Laboratory Improvement Amendments (CLIA) certification or its equivalent.

    • Screening HIV-1 RNA < 40 copies/mL by Abbott RealTime PCR at a laboratory certified by the DAIDS Virology Quality Assurance (VQA) program within 45 days prior to study entry.

    • All known HIV-1 RNA levels obtained within 180 days prior to study entry are below the limits of quantification on all tests, with documentation of at least 1 test by any FDA-approved assay at a CLIA-certified laboratory obtained between 90 to 180 days prior to study entry. A single RNA "blip" of < 500 copies/mL during this time period was permissible if RNA levels immediately before and after were below the limits of quantification for the assay.

    • Laboratory values obtained within 45 days prior to study entry- Absolute neutrophil count (ANC) 750/mm3, Hemoglobin ≥ 9.0 g/dL for female subjects,10.0 g/dL for male subjects, Platelet count ≥ 100,000/mm3, Calculated creatinine clearance (CrCl) 30 mL/min, as estimated by the Cockcroft-Gault equation, Creatine kinase (CK) < 3 x ULN, AST ≤ 2.0 x ULN, ALT ≤ 2.0 x ULN, Total bilirubin ≤ 2.5 x ULN. If the subject was taking an indinavir- or atazanavir-containing regimen at the time of screening, a total bilirubin of ≤ 5 x ULN is acceptable, Fasting LDL cholesterol ≥ 70 mg/dL and < 130 mg/dL, Fasting triglycerides < 400 mg/dL, Fasting glucose < 110 mg/dL

    • Screening plasma D-dimer > 0.34 μg/mL from a sample obtained within 45 days prior to study entry was the original D-dimer criterion. It was revised to ≥ 0.25 ug/mL four months after the first enrollment, and subsequently the D-dimer eligibility criterion was completely cut off a year later.

    • For females of reproductive potential (women who had not been post-menopausal for at least 24 consecutive months, i.e., who had menses within 24 months prior to study entry), or women who had not undergone surgical sterilization, specifically hysterectomy or bilateral oophorectomy or tubal ligation) required a negative serum or urine pregnancy test within 48 hours prior to entry. More information on this criterion can be found in the study protocol.

    • Must agree not to participate in the conception process (e.g., active attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization), and if participating in sexual activity that could lead to pregnancy, the subject/partner must use at least 2 reliable methods of contraception, (condoms, without a spermicidal agent; a diaphragm or cervical cap without spermicide; an IUD; or hormone-based contraceptive), for 2 weeks before study treatment, while receiving study treatment, and for 6 weeks after receiving study treatment. As hormone-based contraceptives (oral, transdermal, or subdermal) can affect coagulopathy biomarkers, subjects who plan on using such a contraceptive during the study must be taking the same product for ≥ 4 weeks prior to screening and be encouraged to continue throughout the duration of the study if medically feasible.

    • Karnofsky performance score ≥ 70 on at least one occasion within 45 days prior to study entry

    • Confirmation of the availability of the stored pre-entry fasting plasma, serum, and cell samples. The site had to confirm that these samples had entered into the Laboratory Data Management System (LDMS).

    Exclusion Criteria:
    • Current or past malignancy (except non-melanoma cancer of the skin)

    • Coronary artery disease (CAD) or CAD equivalent including diabetes mellitus or National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) calculated 10-year coronary heart disease (CHD) risk of > 20%.

    • Known cirrhosis.

    • Known chronic active hepatitis B or C.

    • Thyroid-stimulating hormone (TSH) < 1.0 x lower limit of normal or > 1.0 x ULN.

    • Known inflammatory conditions, such as, but not limited to, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), sarcoidosis, inflammatory bowel disease (IBD), chronic pancreatitis, autoimmune hepatitis, myositis, or myopathy.

    • Pregnant or breast-feeding.

    • Previous intolerance to any statin or any of its components.

    • Use of any lipid-lowering therapies including all statin drugs, Omega 3 fatty acids/fish oil, red yeast rice, and niacin products ≥ 1 g/day (e.g., niacin, nicotinic acid, vitamin B3) taken within 45 days prior to study entry. More information on this criterion can be found in the study protocol.

    • Immunosuppressant use, such as, but not limited to, systemic or potentially systemic glucocorticoids (including nasal or inhaled steroids), azathioprine, tacrolimus, mycophenolate, sirolimus, rapamycin, or cyclosporine within 45 days prior to study entry.

    • Use of any systemic antineoplastic or immunomodulatory treatment, investigational vaccines, interleukins, interferons, growth factors, or intravenous immunoglobulin (IVIG) within 45 days prior to study entry. More information on this criterion can be found in the study protocol.

    • Concurrent use of prohibited medications. More information on this criterion can be found in the study protocol.

    • Heavy alcohol use as defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (http://pubs.niaaa.nih.gov/publications/Practitioner/pocketguide/pocket_guide3.htm) and alcohol or drug use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.

    • Current use of anticoagulation therapy other than ≤ 325 mg of daily aspirin.

    • Known coagulopathy, deep venous thrombosis, pulmonary embolism within 6 months prior to study entry.

    • Known active or recent (not fully resolved within 4 weeks prior to study entry) bacterial, fungal, parasitic, or viral infections.

    • Known history of recurrent rectal and/or genital herpes simplex virus (HSV) or varicella zoster virus (VZV) infection within 12 weeks prior to study entry.

    • Serious illness or trauma requiring systemic treatment and/or hospitalization within 4 weeks prior to study entry.

    • History of stroke.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 31788 Alabama CRS Birmingham Alabama United States 35294
    2 UCLA CARE Center CRS (601) Los Angeles California United States 90095
    3 Ucsd, Avrc Crs (701) San Diego California United States 92103
    4 Harbor-UCLA Med. Ctr. CRS (603) Torrance California United States 90502
    5 University of Colorado Hospital CRS (6101) Aurora Colorado United States 80045
    6 Georgetown University CRS (GU CRS) (1008) Washington District of Columbia United States 20007
    7 Northwestern University CRS (2701) Chicago Illinois United States 60611
    8 Massachusetts General Hospital ACTG CRS (101) Boston Massachusetts United States 02114
    9 Brigham and Women's Hosp. ACTG CRS (107) Boston Massachusetts United States 02115
    10 Beth Israel Deaconess Med. Ctr., ACTG CRS (103) Boston Massachusetts United States 02215
    11 Wayne State Univ. CRS (31478) Detroit Michigan United States 48201
    12 Henry Ford Hosp. CRS (31472) Detroit Michigan United States 48202
    13 Washington U CRS (2101) Saint Louis Missouri United States 63110
    14 Cooper Univ. Hosp. CRS (31476) Camden New Jersey United States 08103
    15 New Jersey Medical School-Adult Clinical Research Ctr. CRS (31486) Newark New Jersey United States 07103
    16 Cornell CRS (7804) New York New York United States 10011
    17 NY Univ. HIV/AIDS CRS (401) New York New York United States 10016
    18 AIDS Care CRS (1101) Rochester New York United States 14642
    19 University of Rochester Adult HIV Therapeutic Strategies Network CRS (31787) Rochester New York United States 14642
    20 Unc Aids Crs (3201) Chapel Hill North Carolina United States 27516
    21 Duke Univ. Med. Ctr. Adult CRS (1601) Durham North Carolina United States 27710
    22 Univ. of Cincinnati CRS (2401) Cincinnati Ohio United States 45267
    23 Case CRS (2501) Cleveland Ohio United States 44106
    24 Metro Health CRS (2503) Cleveland Ohio United States 44109
    25 The Ohio State Univ. AIDS CRS (2301) Columbus Ohio United States 43210
    26 Hosp. of the Univ. of Pennsylvania CRS (6201) Philadelphia Pennsylvania United States 19104
    27 Pitt CRS (1001) Pittsburgh Pennsylvania United States 15213
    28 Houston AIDS Research Team CRS (31473) Houston Texas United States 77030
    29 Virginia Commonwealth Univ. Medical Ctr. CRS (31475) Richmond Virginia United States 23219
    30 University of Washington AIDS CRS (1401) Seattle Washington United States 98104
    31 Puerto Rico-AIDS CRS (5401) San Juan Puerto Rico 00935

    Sponsors and Collaborators

    • AIDS Clinical Trials Group
    • National Institute of Allergy and Infectious Diseases (NIAID)
    • Pfizer

    Investigators

    • Study Chair: Judith A. Aberg, M.D., NYU/Bellevue/HIV/AIDS CTU
    • Study Chair: Daniel E Nixon, D.O., Ph.D., Virginia Commonwealth University Medical Center

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    AIDS Clinical Trials Group
    ClinicalTrials.gov Identifier:
    NCT01351025
    Other Study ID Numbers:
    • ACTG A5275
    • 1U01AI068636
    First Posted:
    May 10, 2011
    Last Update Posted:
    Aug 3, 2021
    Last Verified:
    Jul 1, 2021
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details A5275 opened under version 1.0 on April 7, 2011, and the first participant was randomized on April 14, 2011. Accrual to the study closed on May 31, 2013, with a total of 98 participants enrolled at 31 sites.
    Pre-assignment Detail Four enrolled participants did not start study treatment (3 from arm A and 1 from arm B) due to enrollment error and noncompliance. These 4 participants were not included in the study efficacy or safety analyses.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Period Title: Week 0 - 20
    STARTED 46 48
    COMPLETED 43 47
    NOT COMPLETED 3 1
    Period Title: Week 0 - 20
    STARTED 43 47
    COMPLETED 43 47
    NOT COMPLETED 0 0
    Period Title: Week 0 - 20
    STARTED 43 47
    COMPLETED 42 43
    NOT COMPLETED 1 4
    Period Title: Week 0 - 20
    STARTED 42 43
    COMPLETED 42 43
    NOT COMPLETED 0 0

    Baseline Characteristics

    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin Total
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44. Total of all reporting groups
    Overall Participants 46 48 94
    Age (years) [Median (Inter-Quartile Range) ]
    Median (Inter-Quartile Range) [years]
    47
    50
    48
    Age, Customized (participants) [Number]
    18-29 Years
    3
    6.5%
    2
    4.2%
    5
    5.3%
    30-39 Years
    9
    19.6%
    6
    12.5%
    15
    16%
    40-49 Years
    16
    34.8%
    16
    33.3%
    32
    34%
    50-59 Years
    14
    30.4%
    21
    43.8%
    35
    37.2%
    >=60 Years
    4
    8.7%
    3
    6.3%
    7
    7.4%
    Sex: Female, Male (Count of Participants)
    Female
    17
    37%
    13
    27.1%
    30
    31.9%
    Male
    29
    63%
    35
    72.9%
    64
    68.1%
    Race/Ethnicity, Customized (participants) [Number]
    White non-Hispanic
    10
    21.7%
    13
    27.1%
    23
    24.5%
    Black non-Hispanic
    21
    45.7%
    22
    45.8%
    43
    45.7%
    Hispanic (regardless of race)
    14
    30.4%
    13
    27.1%
    27
    28.7%
    Asian, Pacific Islander
    1
    2.2%
    0
    0%
    1
    1.1%
    Region of Enrollment (participants) [Number]
    United States
    46
    100%
    48
    100%
    94
    100%
    HIV-1 RNA (participants) [Number]
    < assay lower limit
    46
    100%
    47
    97.9%
    93
    98.9%
    >= assay lower limit
    0
    0%
    1
    2.1%
    1
    1.1%
    CD4 count (cells/mm^3) [Median (Inter-Quartile Range) ]
    Median (Inter-Quartile Range) [cells/mm^3]
    587
    545
    552

    Outcome Measures

    1. Primary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in log10 IL-6
    Description IL-6 (Interleukin 6) in log10 pg/mL: Difference between [change from week 24 to week 44] and [change from baseline to week 20] (i.e. [week 44 - week 24] - [week 20 - baseline])
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    The primary analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 34 36
    Median (Inter-Quartile Range) [log10 pg/mL]
    -0.08
    -0.08
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Arm A: Atorvastatin / Placebo, Arm B: Placebo / Atorvastatin
    Comments The null hypothesis is that there is no difference between arm A and arm B in the differences of the changes ([week 44 - week 24] - [week 20 - baseline]) in log10 IL-6
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.94
    Comments Two-sided p-values of < 0.05 without adjustments for multiple testing were considered statistically significant.
    Method Wilcoxon (Mann-Whitney)
    Comments Exact Wilcoxon rank sum test was used
    2. Primary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in CD4+ T-cell Activation Percent
    Description CD4+ T-cell activation percent (% CD38+/DR+ of CD4+): Difference between [change from week 24 to week 44] and [change from baseline to week 20] (i.e. [week 44 - week 24] - [week 20 - baseline])
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    The primary analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 31 34
    Median (Inter-Quartile Range) [percent]
    -0.20
    0.60
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Arm A: Atorvastatin / Placebo, Arm B: Placebo / Atorvastatin
    Comments The null hypothesis is that there is no difference between arm A and arm B in the differences of the changes ([week 44 - week 24] - [week 20 - baseline]) in CD4+ T-cell activation percent (% CD38+/DR+ of CD4)
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.495
    Comments Two-sided p-values of < 0.05 without adjustments for multiple testing were considered statistically significant.
    Method Wilcoxon (Mann-Whitney)
    Comments exact Wilcoxon rank sun test was used
    3. Primary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in log10 D-dimer
    Description D-dimer in log10 ng/mL: Difference between [change from week 24 to week 44] and [change from baseline to week 20] (i.e. [week 44 - week 24] - [week 20 - baseline])
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    The primary analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 34 36
    Median (Inter-Quartile Range) [log10 ng/mL]
    -0.02
    0.00
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Arm A: Atorvastatin / Placebo, Arm B: Placebo / Atorvastatin
    Comments The null hypothesis is that there is no difference between arm A and arm B in the differences of the changes ([week 44 - week 24] - [week 20 - baseline]) in log10 D-dimer
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.704
    Comments Two-sided p-values of < 0.05 without adjustments for multiple testing were considered statistically significant.
    Method Wilcoxon (Mann-Whitney)
    Comments exact Wilcoxon rank sum test was used
    4. Primary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and [Change From Baseline to Week 20] in CD8+ T-cell Activation Percent
    Description CD8+ T-cell activation percent (% CD38+/DR+ of CD8+): Difference between [change from week 24 to week 44] and [change from baseline to week 20] (i.e. [week 44 - week 24] - [week 20 - baseline])
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    The primary analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 31 34
    Median (Inter-Quartile Range) [percent]
    1.10
    -1.15
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Arm A: Atorvastatin / Placebo, Arm B: Placebo / Atorvastatin
    Comments The null hypothesis is that there is no difference between arm A and arm B in the differences of the changes ([week 44 - week 24] - [week 20 - baseline]) in CD8+ T-cell activation percent (% CD38+/DR+ of CD8+)
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.508
    Comments Two-sided p-values of < 0.05 without adjustments for multiple testing were considered statistically significant.
    Method Wilcoxon (Mann-Whitney)
    Comments Exact Wilcoxon rank sum test was used
    5. Secondary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in MCP-1 (log10 Transformed)
    Description Monocyte chemoattractant protein-1 (MCP-1/CCL2) is one of the key chemokines that regulate migration and infiltration of monocytes/macrophages. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    This analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 34 36
    Median (Inter-Quartile Range) [log10 pg/ml]
    0.03
    -0.04
    6. Secondary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in IP-10 (log10 Transformed)
    Description IFN-gamma-inducible protein 10 (IP-10 or CXCL10) is a chemokine secreted from cells stimulated with type I and II IFNs and LPS, is also a chemoattractant for activated T cells. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    This analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 34 36
    Median (Inter-Quartile Range) [log10 pg/ml]
    -0.03
    -0.04
    7. Secondary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in CD40L (log10 Transformed)
    Description Cluster of differentiation 40 (CD40L) is a costimulatory protein found on antigen presenting cells and is required for their activation. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    This analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 34 36
    Median (Inter-Quartile Range) [log10 pg/ml]
    0.01
    -0.03
    8. Secondary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in sCD14 (log10 Transformed)
    Description Soluble cluster of differentiation 14 (sCD14) is a human gene. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    This analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 34 36
    Median (Inter-Quartile Range) [log10 ng/ml]
    0.00
    0.00
    9. Secondary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in P-selectin (log10 Transformed)
    Description P-selectin is a protein that in humans encoded by the SELP gene. P-selectin functions as a cell adhesion molecule (CAM) on the surfaces of activated endothelial cells, which line the inner surface of blood vessels, and activated platelets. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    This analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 34 36
    Median (Inter-Quartile Range) [log10 ng/ml]
    0.01
    -0.06
    10. Secondary Outcome
    Title Difference Between [Change From Week 24 to Week 44] and Change From [Baseline to Week 20] in sCD163 (log10 Transformed)
    Description CD163 (Cluster of Differentiation 163) is a protein that in humans encoded by the CD163 gene; and sCD163 is soluble CD163. Difference between [change from week 24 to week 44] and change from [baseline to week 20] is defined as [week 44 - week 24] - [week 20 - baseline].
    Time Frame baseline, week 20, week 24, and week 44

    Outcome Measure Data

    Analysis Population Description
    This analysis was as-treated, limited to participants who had data for baseline, week 20, week 24, and week 44, and remained on study treatment through week 44 (allowing treatment interruption < 4 weeks), and did not use prohibited medications or have virologic failure during the course of the study.
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 34 36
    Median (Inter-Quartile Range) [log10 ng/ml]
    -0.04
    0.03
    11. Secondary Outcome
    Title Number of Participants With Safety Endpoints Before Study Treatment Cross-over (Baseline to Week 24)
    Description Safety endpoints are defined as grade ≥ 2 signs and symptoms, laboratory abnormalities, AST/ALT > 3 X ULN, and adverse events prior to study treatment cross-over (baseline to week 24). The DAIDS Adverse Event (AE) Grading Table, Version 1.0, December 2004 (Clarification, August 2009) was used for grading of AEs.
    Time Frame week 0 to week 24

    Outcome Measure Data

    Analysis Population Description
    participants who started study treatment
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. atorvastatin: 10 mg daily for 4 weeks, if no symptoms or lab findings suggestive of atorvastatin toxicity, dose increase to 20 mg daily from week 4 - week 20 At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period.
    Measure Participants 46 48
    Number [participants]
    20
    43.5%
    22
    45.8%
    12. Secondary Outcome
    Title Number of Participants With Safety Endpoints After Study Treatment Cross-over (Week 24 to Week 48)
    Description Safety endpoints are defined as grade ≥ 2 signs and symptoms, laboratory abnormalities, AST/ALT > 3 X ULN, and adverse events after study treatment cross-over (week 24 to week 48). The DAIDS Adverse Event (AE) Grading Table, Version 1.0, December 2004 (Clarification, August 2009) was used for grading of AEs.
    Time Frame week 24 to week 48

    Outcome Measure Data

    Analysis Population Description
    participants who crossed over study treatment at week 24
    Arm/Group Title Arm A: Atorvastatin / Placebo Arm B: Placebo / Atorvastatin
    Arm/Group Description At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period. atorvastatin: Starting at week 24, 10 mg daily for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, 20 mg daily from week 28- week 44.
    Measure Participants 41 43
    Number [participants]
    20
    43.5%
    14
    29.2%

    Adverse Events

    Time Frame Week 0 to week 24 (before cross-over) and week 24 to week 48 (after cross-over)
    Adverse Event Reporting Description Wk 0-24 and Wk 24-48 summaries included participants started study rx and participants remained on study rx at wk24, respectively. Protocol required reporting of signs/symptoms/lab values of Gr 2+, events led to a change in study rx, and new diagnoses identified by the ACTG criteria. See DAIDS AE Grading Table v.1, Dec04 (Clarification Aug09).
    Arm/Group Title Arm A: Atorvastatin / Placebo Before Cross-over (Week 0 - 24) Arm B: Placebo / Atorvastatin Before Cross-over (Week 0 - 24) Arm A: Atorvastatin / Placebo After Cross-over (Week 24 - 48) Arm B: Placebo / Atorvastatin After Cross-over (Week 24 - 48)
    Arm/Group Description At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated atorvastatin at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at the week 4 visit. At week 20, atorvastatin was stopped for a 4-week washout period. At study entry (week 0), participants continued the entry boosted PI-based antiretroviral regimen (not provided by the study) and initiated placebo for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the dose of placebo was doubled at the week 4 visit. At week 20, the placebo was stopped for a 4-week washout period. At week 24, placebo was started for 4 weeks. If no symptoms or lab findings suggestive of toxicity were found, the placebo dose was doubled at week 28. At week 44, the placebo was stopped to allow for another 4-week washout period. At week 24, atorvastatin was started at a daily dose of 10 mg for 4 weeks. If no symptoms or lab findings suggestive of atorvastatin toxicity were found, the dose of atorvastatin was increased to 20 mg daily at week 28. At week 44, atorvastatin was stopped to allow for another 4-week washout period.
    All Cause Mortality
    Arm A: Atorvastatin / Placebo Before Cross-over (Week 0 - 24) Arm B: Placebo / Atorvastatin Before Cross-over (Week 0 - 24) Arm A: Atorvastatin / Placebo After Cross-over (Week 24 - 48) Arm B: Placebo / Atorvastatin After Cross-over (Week 24 - 48)
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total / (NaN) / (NaN) / (NaN) / (NaN)
    Serious Adverse Events
    Arm A: Atorvastatin / Placebo Before Cross-over (Week 0 - 24) Arm B: Placebo / Atorvastatin Before Cross-over (Week 0 - 24) Arm A: Atorvastatin / Placebo After Cross-over (Week 24 - 48) Arm B: Placebo / Atorvastatin After Cross-over (Week 24 - 48)
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 4/46 (8.7%) 3/48 (6.3%) 0/41 (0%) 0/43 (0%)
    General disorders
    Chest discomfort 1/46 (2.2%) 0/48 (0%) 0/41 (0%) 0/43 (0%)
    Infections and infestations
    Campylobacter gastroenteritis 1/46 (2.2%) 0/48 (0%) 0/41 (0%) 0/43 (0%)
    Tooth abscess 1/46 (2.2%) 0/48 (0%) 0/41 (0%) 0/43 (0%)
    Urinary tract infection 1/46 (2.2%) 0/48 (0%) 0/41 (0%) 0/43 (0%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Breast cancer 0/46 (0%) 1/48 (2.1%) 0/41 (0%) 0/43 (0%)
    Prostate cancer 0/46 (0%) 1/48 (2.1%) 0/41 (0%) 0/43 (0%)
    Psychiatric disorders
    Depression 0/46 (0%) 1/48 (2.1%) 0/41 (0%) 0/43 (0%)
    Renal and urinary disorders
    Nephrolithiasis 1/46 (2.2%) 0/48 (0%) 0/41 (0%) 0/43 (0%)
    Other (Not Including Serious) Adverse Events
    Arm A: Atorvastatin / Placebo Before Cross-over (Week 0 - 24) Arm B: Placebo / Atorvastatin Before Cross-over (Week 0 - 24) Arm A: Atorvastatin / Placebo After Cross-over (Week 24 - 48) Arm B: Placebo / Atorvastatin After Cross-over (Week 24 - 48)
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 37/46 (80.4%) 44/48 (91.7%) 30/41 (73.2%) 31/43 (72.1%)
    General disorders
    Fatigue 2/46 (4.3%) 5/48 (10.4%) 3/41 (7.3%) 0/43 (0%)
    Investigations
    Alanine aminotransferase abnormal 1/46 (2.2%) 3/48 (6.3%) 0/41 (0%) 0/43 (0%)
    Alanine aminotransferase increased 4/46 (8.7%) 3/48 (6.3%) 3/41 (7.3%) 0/43 (0%)
    Aspartate aminotransferase increased 4/46 (8.7%) 1/48 (2.1%) 3/41 (7.3%) 0/43 (0%)
    Blood alkaline phosphatase increased 4/46 (8.7%) 1/48 (2.1%) 0/41 (0%) 1/43 (2.3%)
    Blood bicarbonate decreased 1/46 (2.2%) 5/48 (10.4%) 0/41 (0%) 1/43 (2.3%)
    Blood bilirubin increased 19/46 (41.3%) 24/48 (50%) 8/41 (19.5%) 20/43 (46.5%)
    Blood cholesterol increased 12/46 (26.1%) 23/48 (47.9%) 15/41 (36.6%) 4/43 (9.3%)
    Blood creatinine increased 1/46 (2.2%) 8/48 (16.7%) 2/41 (4.9%) 7/43 (16.3%)
    Blood glucose decreased 4/46 (8.7%) 5/48 (10.4%) 3/41 (7.3%) 2/43 (4.7%)
    Blood glucose increased 3/46 (6.5%) 9/48 (18.8%) 7/41 (17.1%) 6/43 (14%)
    Blood potassium decreased 3/46 (6.5%) 3/48 (6.3%) 3/41 (7.3%) 1/43 (2.3%)
    Low density lipoprotein increased 7/46 (15.2%) 18/48 (37.5%) 8/41 (19.5%) 0/43 (0%)
    Platelet count decreased 3/46 (6.5%) 2/48 (4.2%) 2/41 (4.9%) 0/43 (0%)
    Musculoskeletal and connective tissue disorders
    Back pain 3/46 (6.5%) 2/48 (4.2%) 1/41 (2.4%) 1/43 (2.3%)
    Pain in extremity 1/46 (2.2%) 0/48 (0%) 4/41 (9.8%) 4/43 (9.3%)
    Nervous system disorders
    Headache 4/46 (8.7%) 2/48 (4.2%) 0/41 (0%) 0/43 (0%)
    Respiratory, thoracic and mediastinal disorders
    Cough 3/46 (6.5%) 4/48 (8.3%) 0/41 (0%) 0/43 (0%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    In accordance with the Clinical Trials Agreement between NIAID (DAIDS) and company collaborators, NIAID (DAIDS) provides companies with a copy of any abstract, press release, or manuscript prior to submission for publication with sufficient time for company review and comment. The publication/other disclosure can be delayed for up to 30 additional business days for manuscripts and five (5) business days for abstracts, to preserve U.S. or foreign patent or other intellectual property rights.

    Results Point of Contact

    Name/Title ACTG Clinicaltrials.gov Coordinator
    Organization ACTG Network Coordinating Center, Social and Scientific Systems, Inc.
    Phone 301-628-3313
    Email ACTGCT.Gov@s-3.com
    Responsible Party:
    AIDS Clinical Trials Group
    ClinicalTrials.gov Identifier:
    NCT01351025
    Other Study ID Numbers:
    • ACTG A5275
    • 1U01AI068636
    First Posted:
    May 10, 2011
    Last Update Posted:
    Aug 3, 2021
    Last Verified:
    Jul 1, 2021