Statins in adult patients with HIV: Protocol for a systematic review and network meta-analysis

Patients with HIV have been found to suffer from lipid abnormalities, including elevated levels of total and LDL-cholesterol as well as triglyceride levels. Abnormal lipid levels are associated with an increased risk of developing cardiovascular diseases, which are significant causes of mortality am...

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Bibliographic Details
Published in:Medicine (Baltimore) 2018-04, Vol.97 (15), p.e0116-e0116
Main Authors: Roever, Leonardo, Resende, Elmiro Santos, Diniz, Angélica Lemos Debs, Penha-Silva, Nilson, O'Connell, João Lucas, Gomes, Paulo Fernando Silva, Zanetti, Hugo Ribeiro, Roerver-Borges, Anaisa Silva, Veloso, Fernando César, Fidale, Thiago Montes, Casella-Filho, Antonio, Dourado, Paulo Magno Martins, Chagas, Antonio Carlos Palandri, Ali-Hasan-Al-Saegh, Sadeq, Reis, Paulo Eduardo Ocke, Pinto, Rogério de Melo, Oliveira, Gustavo B F, Avezum, Álvaro, Neto, Mansueto, Durães, André, Silva, Rose Mary Ferreira Lisboa da, Grande, Antonio José, Denardi, Celise, Lopes, Renato Delascio, Nerlekar, Nitesh, Alizadeh, Shahab, Hernandez, Adrian V, Biondi-Zoccai, Giuseppe
Format: Article
Language:English
Subjects:
Adult
Cardiovascular Diseases - prevention & control
Dyslipidemias - complications
Dyslipidemias - drug therapy
HIV Infections - complications
HIV Infections - therapy
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology
Medication Therapy Management
Randomized Controlled Trials as Topic
Research Design
Study Protocol Systematic Review
Systematic Reviews as Topic
Citations: Items that this one cites
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Summary:Patients with HIV have been found to suffer from lipid abnormalities, including elevated levels of total and LDL-cholesterol as well as triglyceride levels. Abnormal lipid levels are associated with an increased risk of developing cardiovascular diseases, which are significant causes of mortality among the general population. Therefore, the objective of the current study is to conduct a systematic review with network meta-analysis to compare the effects of statins classes on HIV patients. Randomized clinical trials (RCTs) and observational studies published in English up to 31 December 2017, and which include direct and/or indirect evidence, will be included. Studies will be retrieved by searching four electronic databases and cross-referencing. Dual selection and abstraction of data will occur. The primary outcome will all-cause mortality, new event of acute myocardial infarction, stroke (hemorrhagic and ischemic), hospitalization for acute coronary syndrome and urgent revascularization procedures and cardiovascular mortality. Secondary outcomes will be assessment of the differences in change of total cholesterol (TC), low-density lipoprotein (LDL-C), apolipoprotein B (ApoB), high density lipoprotein (HDL-C). Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument for RCTs and the Strengthening the Reporting of Observational Studies in Epidemiology instrument for observational studies. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of statins that reduce cardiovascular mortality in HIV patients. A revised version of the Cochrane Risk of Bias tool (RoB 2.0) will be used to assess the risk of bias in eligible RCTs. Results will be synthesized and analyzed using network meta-analysis (NMA). Overall strength of the evidence and publication bias will be evaluated. Subgroup and sensitivity analysis will also be performed. Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. The evidence will determine which combination of interventions are most promising for current practice and further investigation. PROSPERO (CRD42017072996).
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000010116