Cardiometabolic Effects of Eplerenone in HIV Infection
- Registration Number
- NCT02629094
- Brief Summary
Background:
People with human immunodeficiency virus (HIV) are at a high risk of getting visceral or deep belly fat. Visceral fat can cause health problems like heart or liver disease. Researchers want to see if a blood pressure drug can help by blocking a hormone in the body.
Objective:
To see if eplerenone reduces fat stored in the heart muscle and liver in people with HIV and increased visceral fat.
Eligibility:
Adults ages 18 75 with HIV and increased waist circumference. Increased waist circumference is defined as more than 40 inches in men and more than 35 inches in women.
Design:
Participants will be screened with:
Physical exam
Medical history
Blood tests
Measurements of hips, waist, legs, arms, shoulders, and neck
Magnetic resonance imaging (MRI) scan. They will lie on a table that slides into a machine.
Electrocardiogram (EKG) to measure heart electrical activity
Transient elastography, a special ultrasound to measure liver tissue stiffness
A small piece their liver collected (optional)
Participants will have a baseline visit:
Physical exam
Medical history
Blood tests
DEXA scan to measure body fat, muscle mass, and bone density. Participants will lie on a table while a very small dose of x-rays goes through the body.
Resting energy expenditure (REE). This measures the amount of oxygen breathed in and carbon dioxide breathed out.
Participants will get a 1-week supply of eplerenone. They will take one pill per day.
Participants will have a follow-up visit 1 week later. They will have:
Physical exam
Medical history
Blood tests
23-week supply of eplerenone
Participants will have 5 more follow-up visits.
Participants will have a final study visit, repeating many of the screening and baseline tests.
- Detailed Description
HIV-infected individuals are at higher risk than uninfected people for developing cardiovascular disease. Visceral adipose tissue is also increased in HIV-infected people compared to uninfected individuals. Animal studies suggest that blockade of the mineralocorticoid receptor (MR) may have beneficial effects on cardiovascular and metabolic parameters via inhibition of adipocyte differentiation and triglyceride accumulation. We will examine the effects of the MR antagonist eplerenone (50 mg daily) on HIV-infected adults with abdominal fat accumulation in a 24-week, open-label, proof-of-concept study. Magnetic resonance imaging will be conducted at screening and the final study visit to evaluate cardiac and hepatic steatosis. We anticipate that blocking the effects of increased aldosterone secretion with eplerenone will significantly reduce intramyocardial lipid content and hepatic steatosis in this population. These effects may be accompanied by decreases in visceral adipose tissue, and improvements in dyslipidemia and inflammation, thereby improving cardiovascular health.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 5
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Treatment Inspra /Eplerenone Intervention: Eplerenone will be administered for 6 months as follows: 25 mg once daily for 1 week and then 50 mg once daily for the remainder of the study.
- Primary Outcome Measures
Name Time Method Improvement of Cardiac Steatosis: Mean Change in Intraventricular Septum Percentage of Lipid by MR Spectroscopy. 24 weeks Mean change in intraventricular septum percentage of lipid by MR spectroscopy. This was calculated by subtracting the baseline intraventicular septum percentage value of lipid from the week 24 intraventicular septum percentage value of lipid by MR spectroscopy.
Improvement of Hepatic Steatosis: Mean Change in Hepatic Percentage of Lipid by MR Spectroscopy 24 weeks Mean change in hepatic percentage of lipid by MR spectroscopy. This was calculated by subtracting the baseline hepatic percentage value of lipid from the week 24 hepatic percentage value of lipid by MR spectroscopy.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
National Institutes of Health Clinical Center, 9000 Rockville Pike
🇺🇸Bethesda, Maryland, United States