Monitoring among patients at risk for metabolic syndrome secondary to concomitant antiretroviral and second-generation antipsychotic therapy in an HIV patient population

Abstract

Purpose: Second-generation antipsychotics (SGAs) and protease inhibitors (PIs) have significant metabolic side effect profiles. These risks are compounded with concomitant therapy, both due to additive side effects and as a result of the interaction between the classes which can increase serum SGA concentrations. The goal of this study is to explore the prevalence of metabolic syndrome among patients on concurrent SGA and PI therapy compared to SGA use with other antiretroviral therapy (ART) and to evaluate current risk management practices.

Introduction to Methods: This study has been approved by the Institutional Review Board. Monitoring, incidence of metabolic syndrome, and dosage adjustments among patients taking both SGAs and PIs will be compared to those on concomitant SGA and either integrase inhibitor or non-nucleoside reverse transcriptase inhibitor therapy. A retrospective review of a randomized selection of 100 charts of patients taking both SGAs and ART from September 1, 2017 to September 1, 2018 will be conducted. Monitoring frequency and parameters will be compared to that recommended by the American Diabetes Association for individuals taking SGAs. Our goal is to determine the prevalence of patients at risk for the potential long-term consequences of SGA and PI combination therapy compared to other ART and to evaluate current clinical monitoring and preventative strategies that are in place.