Fish Oil and Fenofibrate for the Treatment of Hypertriglyceridemia in HIV-Infected Subjects on Antiretroviral Therapy: Results of ACTG A5186

What this study found

Fish oil and fenofibrate each significantly lowered triglycerides, and adding the second agent produced additional reductions. In the fish oil arm, triglycerides fell from 668 mg/dL at baseline to 362 mg/dL at week 8, and in the fenofibrate arm they also decreased significantly by week 8, both with P < 0.001. In step 2, combined therapy lowered median triglycerides from 377 mg/dL to 279 mg/dL overall, with an absolute change of 2108 and P < 0.001; 22.7% (17 of 75) responded in step 2, with no significant difference by treatment sequence (21.4% vs 24.2%). The regimen was well tolerated, with…

Study & population

HIV-infected adults on highly active antiretroviral therapy with fasting hypertriglyceridemia that was not adequately controlled with prior monotherapy were studied.

Intervention

Step 1 active treatment was fish oil 3 g twice daily with meals in one arm and fenofibrate 160 mg once daily in the other arm.

Key limitation

The active treatment phases were short, with only 8 weeks of monotherapy followed by 8 weeks of combination therapy, so long-term durability is unknown.

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