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Titolo:
PARENTERAL CIDOFOVIR FOR CYTOMEGALOVIRUS RETINITIS IN PATIENTS WITH AIDS - THE HPMPC PERIPHERAL CYTOMEGALOVIRUS RETINITIS TRIAL - A RANDOMIZED, CONTROLLED TRIAL
Autore:
LEWIS RA; CARR LM; DOYLE K; FAINSTEIN V; GROSS R; ORENGONANIA S; SAMO TC; SHIGLEY JW; SPENCER SS; WEINERT M; DUNN JP; BARTLETT J; BECKER R; FEINBERG J; JABS DA; JOHNSON DA; LASALVIA S; MILLER T; NEISSER LG; SEMBA RD; TAYKEARNEY ML; TUCKER P; BARRON B; JARROTT C; PEYMAN G; SWENIE D; FRIEDMAN AH; GINSBURG R; SACKS H; SEVERIN C; TEICH S; WALLACH F; RESCIGNO R; COWAN J; HORAN C; KLOSER P; WANNER M; FRIEDBERG DN; ADDESSI A; CHACHOUA A; DIETERICH D; HILL J; HUTT R; LIGH J; LORENZOLATKANY M; PEI M; POWERS T; SCOPPE C; WEINBERG DV; JAMPOL LM; LYON AT; MUNANA A; MURPHY R; PALELLA F; RICHINE L; STRUGALA Z; VALADEZ G; HOLLAND GN; CARLSON ME; CHAFEY S; HARDY WD; JOHIRO AK; MACARTHURCHANG L; MARTIN MA; MOE AA; STRONG CA; TUFAIL A; UGALAT PS; WEISZ JM; FREEMAN WR; AREVALOCOLINA JF; CLARK T; JARMAN CL; MEIXNER L; MENG TC; SPECTOR S; TASKINTUNA I; TORRIANI FJ; ODONNELL J; ALFRED P; BALLESTEROS F; CLAY D; COLEMAN R; GUMBLEY D; HOFFMAN J; IRVINE A; JACOBSON M; LARSON J; MACALALAG L; NARAHARA M; PAYNE M; SEIFF S; WILSON S; WOODRING H; DAVIS J; MENDEZ P; MURRAY T; SIMMONS T; VANDERHORST C; KYLSTRA J; WOHL D; ZIMAN K; PAVAN PR; BERGEN GA; COHEN SM; CRAIG JA; DEHLER RL; ELBERT E; FOX RW; GRIZZARD WS; HAMMER ME; HERNANDEZ LS; HERRERA S; HOLT D; KEMP S; LARKIN JA; LEDFORD DK; LOCKEY RF; MENOSKY MM; MILLARD S; NADLER JP; NELSON RP; NORRIS D; ORMEROD LD; PAUTLER SE; POBLETE SJ; RODRIGUEZ D; ROSENBACH KP; SEEKINS DW; TONEY JR; DODGE JM; KLEMSTINE JL; SCHUERHOLTZ TA; STEVENS M; MEINERT CL; AMENDLIBERCCI D; COLESON L; COLLINS KL; COLLISON BJ; DAWSON C; DODGE J; DONITHAN M; EWING C; FINK N; GERCZAK C; HARLE J; HOLBROOK JT; HUFFMAN R; ISAACSON MR; GILPIN AMK; LANE M; LEVINE CR; MARTIN B; MEINERT J; NOWAKOWSKI DJ; OWENS RM; PIANTADOSI B; SAAH A; SMITH M; TONASCIA J; VANNATTA ML; DAVIS MD; ARMSTRONG J; BRICKBAUER J; BROTHERS R; CHOP M; HUBBARD L; HURLBURT D; KASTORFF L; MAGLI Y; NEIDER M; ONOFREY J; STOPPENBACH V; VANDERHOOFYOUNG M; WALLS M; HUGHES R; KURINIJ N; MOWERY RL; ALSTON B; FOULKES M; FREEMAN W; HOLBROOK J; MEINERT C; MOWERY R; POLSKY B; DUNCAN WR; KESSLER H; LAMBERT AG; POWDERLY W; SCHNITTMAN S; SPECTOR S; BROWN BW; CONWAY B; GRIZZLE J; NUSSENBLATT R; PHAIR JP; SMITH H; WHITLEY R; CHENG B; FROST K; MARCO M;
Indirizzi:
JOHNS HOPKINS UNIV,WILMER OPHTHALMOL INST,AIDS CHAIRMANS OFF,SCH MED,550 N BROADWAY,SUITE 700 BALTIMORE MD 21205 BAYLOR COLL MED HOUSTON TX 77030 CULLEN EYE INST HOUSTON TX 00000 JOHNS HOPKINS UNIV,SCH MED BALTIMORE MD 00000 LOUISIANA STATE UNIV,MED CTR NEW ORLEANS LA 00000 MT SINAI SCH MED NEW YORK NY 00000 UNIV MED & DENT NEW JERSEY,NEW JERSEY MED SCH NEWARK NJ 07103 NYU,MED CTR NEW YORK NY 10016 NORTHWESTERN UNIV CHICAGO IL 60611 UNIV CALIF LOS ANGELES LOS ANGELES CA 90024 UNIV CALIF SAN DIEGO SAN DIEGO CA 92103 UNIV CALIF SAN FRANCISCO SAN FRANCISCO CA 94143 UNIV MIAMI,SCH MED MIAMI FL 00000 UNIV N CAROLINA CHAPEL HILL NC 27515 UNIV S FLORIDA TAMPA FL 00000 JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH BALTIMORE MD 21218 UNIV WISCONSIN,PHOTOGRAPH READING CTR MADISON WI 00000 MCKESSON BIOSERV CORP,DRUG DISTRIBUT CTR ROCKVILLE MD 00000 NEI BETHESDA MD 20892 NIAID BETHESDA MD 20892
Titolo Testata:
Annals of internal medicine
fascicolo: 4, volume: 126, anno: 1997,
pagine: 264 -
SICI:
0003-4819(1997)126:4<264:PCFCRI>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; NUCLEOTIDE ANALOG; GANCICLOVIR; -1-)3-HYDROXY-2-(PHOSPHONYLMETHOXY)PROPYL>CYTOSINE; S)-1-(3-HYDROXY-2-PHOSPHONYLMETHOXYPROPYL)CYTOSINE; ZIDOVUDINE; INFECTION; DISEASE; MODELS;
Keywords:
CIDOFOVIR; CYTOMEGALOVIRUS RETINITIS; ACQUIRED IMMUNODEFICIENCY SYNDROME; VISION DISORDERS; PROBENECID;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
37
Recensione:
Indirizzi per estratti:
Citazione:
R.A. Lewis et al., "PARENTERAL CIDOFOVIR FOR CYTOMEGALOVIRUS RETINITIS IN PATIENTS WITH AIDS - THE HPMPC PERIPHERAL CYTOMEGALOVIRUS RETINITIS TRIAL - A RANDOMIZED, CONTROLLED TRIAL", Annals of internal medicine, 126(4), 1997, pp. 264

Abstract

Background: Cytomegalovirus (CMV) retinitis is a common infection anda major cause of visual loss in patients with the acquired immunodeficiency syndrome (AIDS). Objective: To evaluate intravenous cidofovir as a treatment for CMV retinitis.Design: Two-stage, multicenter, phase II/III, randomized, controlled clinical trial. Setting: Ophthalmology and AIDS services at tertiary care medical centers. Patients: 64 patients with AIDS and previously untreated, small, peripheral CMV retinitis lesions (that is, patients at low risk for loss of visual acuity).Intervention: Patients were randomly assigned to one of three groups: the deferral group, in which treatment was deferred until retinitis progressed; the low-dose cidofovir group, which received cidofovir, 5 mg/kg of body weight once weekly for 2 weeks, then maintenance therapy with cidofovir, 3 mg/kg once every 2 weeks; or the high-dose cidofovir group, which received cidofovir, 5 mg/kg once weekly for 2 weeks, then maintenance therapy with cidofovir, 5 mg/kg once every 2 weeks. To minimize nephrotoxicity, cidofovir was administered with hydration and probenecid. Measurements: Progression of retinitis, evaluated in a maskedmanner by a fundus photograph reading center; the amount of retinal area involved by CMV; the loss of visual acuity; and morbidity. Results: Median time to progression was 64 days in the low-dose cidofovir group and 21 days in the deferral group (P = 0.052, log-rank test). The median time to progression was not reached in the high-dose cidofovir group but was 20 days in the deferral group (P = 0.009, log-rank test). Analysis of the rates of increase in the retinal area affected by CMVconfirmed the data on time to progression. The three groups had similar rates of visual loss. Proteinuria of 2+ or more occurred at rates of 2.6 per person-year in the deferral group, 2.8 per person-year in the low-dose cidofovir group (P > 0.2), and 6.8 per person-year in the high-dose cidofovir group (P = 0.135). No patient developed 4+ proteinuria, but two cidofovir recipients developed persistent elevations of serum creatinine levels at more than 177 mu mol/L (2.0 mg/dL). Reactions to probenecid occurred at a rate of 0.70 per person-year. Conclusions: Intravenous cidofovir, high- or low-dose, effectively slowed the progression of CMV retinitis. Concomitant probenecid and hydration therapy, intermittent dosing, and monitoring for proteinuria seemed to minimize but not eliminate the risk for nephrotoxicity.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/07/20 alle ore 16:54:31