Tesamorelin for the treatment of excess abdominal fat in HIV-1-infected patients with lipodystrophy.

Expert review of endocrinology & metabolism2011PMID: 30764032

Plain Language Summary

Narrative review covering tesamorelin's pharmacology, mechanism of action as a GHRH analog, clinical evidence for visceral fat reduction and lipid improvement in HIV lipodystrophy, FDA approval for HIV-associated excess abdominal fat, safety profile, and practical considerations for its use as the primary treatment for visceral adiposity in HIV-positive patients. Provides a comprehensive tesamorelin clinical reference. Establishes the clinical evidence base for tesamorelin as the FDA-approved treatment for HIV-associated lipodystrophy—synthesizing the phase III trial results, mechanism of action, durability of effect, and safety considerations for practitioners managing HIV-associated body composition changes.

Abstract

Morphologic and metabolic abnormalities remain a common problem in patients with HIV-1 infection, which contributes to poor self image and may negatively impact on patient's adherence to medication and success of therapy. In addition, these physiological and metabolic changes can lead to increased cardiovascular risk. In such patients, excess central fat could be associated with loss of subcutaneous fat. Several strategies to decrease the excess of visceral fat have been assessed. Tesamorelin, an injectable growth hormone-releasing factor analogue, has been shown to improve visceral fat adiposity with relatively little effect on subcutaneous fat with improvement in triglycerides and belly appearance distress. It is well tolerated overall without clinically significant changes in mean glucose or insulin levels. However, these benefits cease if treatment is discontinued.

Authors

Mateo, Maria Gracia; Gutiérrez, Maria Del Mar; Domingo, Pere

Keywords

HIV-1 infectionexcess abdominal fatgrowth hormone-releasing factor analoguelipodystrophytesamorelin