Drugs

Losartan

Losartan

Other Names: Cozaar, losartan potassium Drug Class: Antifibrotics Molecular Formula: C22 H23 Cl N6 O Registry Number: 114798-26-4 (CAS) Chemical Name: (1-((2'-(2H-Tetrazol-5-yl)biphenyl-4-yl)methyl)-2-butyl-4-chloro-1H-imidazol-5-yl)methanol Chemical Class: Biphenyls and derivatives Organization: Merck Sharp & Dohme Corp. Phase of Development: Losartan is in Phase II development for HIV.

(Compound details obtained from ChemIDplus Advanced,1 Treatment Action Group website,2 DrugBank,3 and ClinicalTrials.gov4,5)

What is losartan?

What is losartan?

Losartan is being studied as part of a strategy to treat or cure HIV infection.4–6 Losartan is currently approved by the U.S. Food and Drug Administration (FDA) to treat high blood pressure and kidney damage caused by diabetes under the brand name Cozaar. It can also help reduce the risk of stroke in certain people.7

As an investigational therapy, losartan belongs to a group of drugs called antifibrotics.2 Antifibrotics are medicines that can reduce tissue scarring in the body. (Tissue scarring is also called fibrosis.)8

HIV infection can overwork the body’s immune system, leading to fibrosis in lymphoid tissues. Fibrosis in lymphoid tissues may damage the body's immune system.8–11

By reducing fibrosis, losartan could potentially improve the health of the immune system. Losartan may also help reduce the size of the latent HIV reservoir in the body. Latent HIV reservoirs are resting immune cells that are infected with HIV but are not actively producing HIV. Because HIV medicines do not work against HIV hiding in latent reservoirs, these reservoirs are one of the main obstacles to curing HIV infection.4,6,8,10,11

To learn about how investigational drugs are tested during clinical trials, read the AIDSinfo What is an Investigational HIV Drug? and HIV/AIDS Clinical Trials fact sheets.

Which clinical trials are studying losartan?

Which clinical trials are studying losartan?

Study Name: NCT01852942
Phase: II
Status: This study is ongoing, but not recruiting participants.
Location: United States
Purpose: The purpose of this study is to determine if losartan can reduce fibrosis in lymphoid tissues, calm an overactive immune system, improve immune system recovery, and decrease the size of the latent HIV reservoir in the body. The study will also assess losartan’s safety.4

Study Names: LIFE-HIV trial; NCT02049307
Phase: II
Status: This study is ongoing, but not recruiting participants.
Location: United States
Purpose: The purpose of this study is to determine how well losartan reduces inflammation and fibrosis to improve immune system recovery.5,6

Study Name: NCT01529749
Phase: IV
Status: This study has been completed.
Location: Spain
Purpose: The purpose of this study was to evaluate the effect of losartan and an ART regimen containing raltegravir on fibrosis in lymphoid tissues. The study also looked at whether the drug could decrease risk factors of inflammation and cardiovascular disease.12–14

For more details on the studies listed above, see the Health Professional version of this drug summary.

What side effects might losartan cause?

What side effects might losartan cause?

Side effects have not yet been reported in the clinical trials that are studying losartan to treat HIV.

Side effects that are already known to be associated with losartan are described in the FDA-approved Full Prescribing Information for Cozaar.7

Because losartan is still being studied, information on possible side effects of the drug is not complete. As testing of losartan continues, additional information on possible side effects will be gathered.

Where can I get more information about clinical trials studying losartan?

Where can I get more information about clinical trials studying losartan?

More information about losartan-related research studies is available from the AIDSinfo database of ClinicalTrials.gov study summaries. Click on the title of any trial in the list to see the ClinicalTrials.gov trial summary and more information about the study.

Some clinical trials may be looking for volunteer participants. Your health care provider can help you decide whether participating in a clinical trial is right for you. For information, visit NIH Clinical Research Trials and You.

References

References

  1. United States National Library of Medicine. ChemIDplus Advanced: Losartan. https://chem.nlm.nih.gov/chemidplus/rn/114798-26-4. Accessed September 10, 2018.
  2. Treatment Action Group website. Research toward a cure trials. http://www.treatmentactiongroup.org/cure/trials. Accessed September 10, 2018.
  3. DrugBank. Losartan. https://www.drugbank.ca/drugs/DB00678. Accessed September 10, 2018.
  4. University of Minnesota - Clinical and Translational Science Institute. Reversing tissue fibrosis to improve immune reconstitution in HIV. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on February 20, 2012. NLM Identifier: NCT01852942. https://clinicaltrials.gov/ct2/show/NCT01852942. Accessed September 10, 2018.
  5. Minneapolis Medical Research Foundation. Losartan to reduce inflammation and fibrosis endpoints in HIV trial. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on January 27, 2014. NLM Identifier: NCT02049307. https://clinicaltrials.gov/ct2/show/NCT02049307. Accessed September 10, 2018.
  6. National Institute of Allergy and Infectious Diseases. LIFE-HIV study. https://www.niaid.nih.gov/clinical-trials/life-hiv-study. Accessed September 10, 2018.
  7. Merck Sharp & Dohme Corp. Cozaar: full prescribing information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5ac32c20-169d-475a-fc8a-934f758d6ab0. Accessed September 10, 2018.
  8. Zeng M, Southern PJ, Reilly CS, et al. Lymphoid tissue damage in HIV-1 infection depletes naïve T cells and limits T cell reconstitution after antiretroviral therapy. PLoS Pathog. 2012;8(1). doi:10.1371/journal.ppat.1002437
  9. Zeng M, Smith AJ, Wietgrefe SW, et al. Cumulative mechanisms of lymphoid tissue fibrosis and T cell depletion in HIV-1 and SIV infections. J Clin Invest. 2011;121(3):998–1008. doi:10.1172/JCI45157
  10. Douek DC. Immune activation, HIV persistence, and the cure. Top Antivir Med. 2013;21(4):128-132.
  11. Hatano H. Immune Activation and HIV Persistence: Considerations for Novel Therapeutic Interventions. Curr Opin HIV AIDS. 2013;8(3):211-216. doi:10.1097/COH.0b013e32835f9788
  12. Felipe Garcia. Effects of losartan and antiretroviral regimen containing raltegravir in fibrosis inflammation. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on February 8, 2012. NLM Identifier: NCT01529749. https://clinicaltrials.gov/ct2/show/NCT01529749. Accessed September 10, 2018.
  13. Torres B, Guardo AC, Caballero M, et al. Effects of losartan on lymphoid tissue fibrosis, markers of inflammation and cardiovascular risk in virologically supressed HIV patients after 48 weeks. Poster presented at: 8th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment & Prevention; July 19-22, 2015; Vancouver, Canada. Poster MOPEA027. http://pag.ias2015.org/PAGMaterial/eposters/1653.pdf. Accessed September 10, 2018.
  14. Torres B, Guardo AC, and Fabra A, et al. Effect of switching to raltegravir and/or adding losartan on HIV immune activation. Poster presented at: Conference on Retroviruses and Opportunistic Infections (CROI); March 4-7, 2018; Boston, MA. Poster 314. https://www.croiconference.org/sites/default/files/posters-2018/1430_Leal_314.pdf. Accessed September 10, 2018.

Last Reviewed: September 10, 2018