Efficacy and Safety of Tesamorelin in People Living With HIV (PLWH) With Lipodystrophy: A Systematic Review and Meta-Analysis.

Systematic review and meta-analysis of randomized controlled trials

“We conducted a comprehensive systematic review and meta-analysis incorporating GRADE assessment to evaluate the efficacy and safety of tesamorelin in PLWH with lipodystrophy receiving CART”

Adults with HIV infection and antiretroviral therapy-associated lipodystrophy

“enrolled adults (≥18 years) with HIV infection and documented antiretroviral therapy-associated lipodystrophy characterized by excess visceral abdominal fat”

909 patients across four randomized controlled trials

“Four RCTs (909 patients) were included.”

Tesamorelin significantly reduced visceral adipose tissue, waist circumference, and trunk fat while increasing lean body mass.

“Tesamorelin 2mg significantly reduced visceral adipose tissue (MD= -21.47, 95%CI[-34.73,-8.22],I2=74%,p=0.002), waist circumference (MD-1.61cm,95% CI[-2.28,-0.95],I2=0%,p<0.00001), trunk fat (MD-1.20kg, 95%CI[-1.47,-0.93],I2=0%,p<0.00001), and increased lean body mass (MD1.42kg,95% CI[1.13,1.71],I2=0%,p<0.00001).”

Modest improvements were observed in total cholesterol levels.

“Modest lipid improvements occurred in total cholesterol (MD-0.16mmol/L,95%CI[-0.27,-0.06],I2=0%,p=0.003).”

Growth hormone-related adverse effects and higher discontinuation rates were observed.

“Growth hormone-related adverse effects and higher discontinuation rates (RR2.25,95%CI[0.98,5.17],p=0.06) were observed.”