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Articles by Adrian Dobs
Total Records ( 2 ) for Adrian Dobs
  Jag H. Khalsa , Frank Vocci and Adrian Dobs
  There are an estimated 200 million users of an illicit drug in the world today. In addition, an estimated 40 million people are infected with the human immunodeficiency virus (HIV) and an estimated 180 million people are infected with the hepatitis C virus (HCV). Both the use of an illicit drug and the co-occurrence of infections are associated with a multitude of medical and health consequences including hormonal and metabolic disorders. Thus, the National Institute on Drug Abuse (NIDA), a part of the National Institutes of Health (NIH) hosted a workshop on hormonal and metabolic disorders of HIV among substance abusers. A number of clinicians and scientists participated and discussed a wide range of issues concerning hormones, nutrition and metabolic complications in HIV and substance abuse. Their observations and the recommendations they made for future research are presented in these proceedings. The readers are encouraged to contact the NIH staff (JK, FV) for technical guidance and programmatic priorities on the subject and directly contact the individual authors for collaborations.
  Adrian Dobs , Michael Miller , Paul T. DeLucca , Karen E. Ramsey , Andrew M. Tershakovec and Wendy Horn
 

Background

Low-density lipoprotein cholesterol (LDL-C) has been identified as the primary target of cholesterol-lowering therapy, with the LDL-C goal set at ≤100 mg/dL for patients at high risk, such as those with diabetes.

Objective

To evaluate the efficacy of simvastatin (S) in achieving LDL-C levels <70 mg/dL in patients with type 2 diabetes mellitus (DM).

Methods

This was a post-hoc analysis of a multicenter, randomized, double-blind, three-way crossover, placebo (PL)-controlled study that evaluated S80 mg or S40 mg versus PL for increasing high-density lipoprotein cholesterol (HDL-C). Patients with type 2 DM (n = 151), LDL-C >100 mg/dL, HDL-C <40 mg/dL, and triglycerides (TG) >150 and <700 mg/dL were randomized to daily S80 mg, S40 mg, or PL for three 6-week periods. The percentage of patients reaching LDL-C <70 mg/dL and the percentage reaching TG <150 mg/dL after 6 weeks was assessed.

Results

After 6 weeks, 59% (82 of 140) of patients in the S80 mg group achieved LDL-C <70 mg/dL versus 43% (60 of 139) receiving S40 m, and 0% (0 fo 140) in the PL group (P < 0.001 for S80 mg and S40 mg vs PL, and S80 mg vs S40 mg). In patients with coronary heart disease (CHD) (n = 32), 63% (20 of 32) receiving S80 mg reached LDL-C <70 mg/dL, versus 50% (15 of 30) in the S40 mg and 0% (0 of 32) in the PL group (P <0.001 for S80 mg and S40 mg vs PL, and P = 0.063 for S80 mg vs S40 mg). For TG levels, 27% (35 of 132) of the S80 mg patients and 23% (30 of 130) of the S40 mg patients reached a goal of TG <150 mg/dL. The dual goal of LDL-C level <70 mg/dL and TG level <150 mg/dL was attained by 14.7% of patients in the S80 mg, 7.8% in the S40 mg, and 0% in the PL group.

Conclusion

S40 mg or S80 mg daily allowed 43% to 59% of patients with type 2 DM at risk of CHD to reach the goal of lowering LDL-C levels to the National Cholesterol Education Program Adult Treatment Panel III optional target level of <70 mg/dL. Reaching TG goals may require additional therapeutic considerations.

 
 
 
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