Fixed-dose pitavastatin reduces cardiovascular events in patients with HIV: NNT = 82 over 5 years (REPRIEVE)

Clinical Question

Does pitavastatin reduce the likelihood of cardiovascular events in persons with human immunodeficiency virus infection?

Bottom line

In adults aged 40 to 75 years with HIV disease and at low to moderate risk for cardiovascular disease, pitavastatin 4 mg once daily resulted in a modest reduction in the risk of a major cardiovascular event (NNT = 400). Based on the survival curve, it looks like the benefit was consistent across the follow-up period, so over 10 years that NNT would be only 40. The cost of pitavastatin (Livalo) is $332 per month, so it may be worth working with a pharmacist to identify a lower cost statin that does not interact with your patient's specific antiretroviral regimen.  1b

Study design: Randomized controlled trial (double-blinded)

Funding: Industry + govt

Setting: Outpatient (any)

Reviewer

Mark H. Ebell, MD, MS
Professor
University of Georgia
Athens, GA


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Comments

ARUP KUMAR DHARA

Impact assessment

Excellent

Anonymous

None

No