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Titolo:
ORAL GANCICLOVIR AS MAINTENANCE TREATMENT FOR CYTOMEGALOVIRUS RETINITIS IN PATIENTS WITH AIDS
Autore:
DREW WL; IVES D; LALEZARI JP; CRUMPACKER C; FOLLANSBEE SE; SPECTOR SA; BENSON CA; FRIEDBERG DN; HUBBARD L; STEMPIEN MJ; SHADMAN A; BUHLES W;
Indirizzi:
UNIV CALIF SAN FRANCISCO,MT ZION MED CTR,POB 7921 SAN FRANCISCO CA 94120 BETH ISRAEL HOSP BOSTON MA 02215 DAVIES MED CTR SAN FRANCISCO CA 94114 UNIV CALIF SAN DIEGO SAN DIEGO CA 92103 RUSH MED COLL CHICAGO IL 60612 NYU,MED CTR NEW YORK NY 00000 UNIV WISCONSIN MADISON WI 00000 SYNTEX INC,DEV RES PALO ALTO CA 94304
Titolo Testata:
The New England journal of medicine
fascicolo: 10, volume: 333, anno: 1995,
pagine: 615 - 620
SICI:
0028-4793(1995)333:10<615:OGAMTF>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNE-DEFICIENCY SYNDROME; ACQUIRED IMMUNODEFICIENCY SYNDROME; VIRUS RETINITIS; OCULAR MANIFESTATIONS; FOSCARNET; THERAPY; INFECTION; DISEASE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
W.L. Drew et al., "ORAL GANCICLOVIR AS MAINTENANCE TREATMENT FOR CYTOMEGALOVIRUS RETINITIS IN PATIENTS WITH AIDS", The New England journal of medicine, 333(10), 1995, pp. 615-620

Abstract

Background. Cytomegalovirus retinitis, a sight threatening infection associated with the acquired immunodeficiency syndrome (AIDS), currently requires lifelong intravenous treatment. An effective oral treatment would bean important advance. Methods. We compared oral with intravenous ganciclovir in an open-label, randomized study in patients with AIDS and newly diagnosed, stable cytomegalovirus retinitis (the diseasewas stabilized by three weeks of treatment with intravenous ganciclovir). Sixty subjects were randomly assigned to maintenance therapy withintravenous ganciclovir at a dose of 5 mg per kilogram of body weightdaily, and 63 to maintenance therapy with oral ganciclovir at a dose of 3000 mg daily. The subjects were followed for up to 20 weeks, with photography of the fundi conducted every other week. The photographs were evaluated at the completion of the study by an experienced grader who was unaware of the subjects' treatment assignments. Results. Efficacy could be evaluated in 117 subjects; photographs were ungradable for 2 of the 117. On the basis of the masked assessment of photographs from 115 subjects, the mean time to the progression of retinitis was 62days in those given intravenous ganciclovir and 57 days in those given oral ganciclovir (P=0.63; relative risk [oral vs. intravenous], 1.08; 95 percent confidence interval for the difference in means, -22 to +12 days). On the basis of funduscopy by ophthalmologists who were aware of the subjects' treatment assignments, the mean time to progressionwas 96 days in subjects given intravenous ganciclovir and 68 days in subjects given oral ganciclovir (P=0.03; relative risk [oral vs. intravenous], 1.68; 95 percent confidence interval for the difference in means, -45 to -11 days). Survival, changes in visual acuity, the incidence of viral shedding, and the incidence of adverse gastrointestinal events were similar in the two groups. Neutropenia, anemia, intravenous-catheter-related adverse events, and sepsis were more common in the group given intravenous ganciclovir. Conclusions. Oral ganciclovir is safe and effective as maintenance therapy for cytomegalovirus retinitis and is more convenient for patients to take than intravenous ganciclovir.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 19:43:49