A Dose-Ranging Study of Daily Maintenance Intravenous Foscarnet Therapy for Cytomegalovirus Retinitis in AIDS

• Published in: The Journal of infectious diseases Vol. 168; no. 2; pp. 444 - 448
• Main Authors: Jacobson, Mark A., Causey, Dennis, Polsky, Bruce, Hardy, David, Chown, Marilyn, Davis, Roger, Donnell, James J. O, Kuppermann, Baruch D., Heinemann, Murk-Hein, Holland, Gary N., Mills, John, Feinberg, Judith E.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.08.1993; University of Chicago Press
• Subjects: Adolescent; Adult; Aged; AIDS; AIDS-Related Opportunistic Infections - drug therapy; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Biological and medical sciences; Blood; Cytomegalovirus; Cytomegalovirus Infections - drug therapy; Cytomegalovirus retinitis; Dosage; Experimentation; Foscarnet - administration & dosage; Foscarnet - adverse effects; Foscarnet - therapeutic use; Health care administration; Humans; Injections, Intravenous; Medical sciences; Middle Aged; Ophthalmology; Pharmacology. Drug treatments; Retinitis; Retinitis - drug therapy; Urine; Human; Immunopathology; Cytomegalovirus; Retinopathy; Renal function; Intravenous administration; Toxicity; Herpesviridae; Treatment efficiency; AIDS; Hemopathy; Betaherpesvirinae; Survival; Infection; Virus; Eye disease; Chemotherapy; Treatment; Viral disease; Antiviral; Retinitis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/168.2.444

Thirty-two patients with AIDS and previously untreated cytomegalovirus retinitis completed an induction course of foscarnet, 60 mg/kg every 8 h for 14 days, had retinitis stabilize, and were then randomly assigned to receive foscarnet maintenance as either a 90- or 120-mg/kg/day infusion administered over 2 h. Median survival was 157 and 336 days for the 90- and 120-mg/kg/day groups, respectively (P < .001). In an independent, masked analysis of retinal photographs, median time to progression ofretinitis was 31 versus 95 days (P = .13). Daily intravenous foscarnet at a dose of 120 mg/kg (adjusted for renal function) resulted in significantly longer survival and tended to increase time to retinitis progression compared to the standard 90-mg/kg/day maintenance dose. Although a substantial increase in the risk of serious toxicity at the 120-mg/kg/day dose was not observed, the small sample size in this trial limited the power to detect differences that might be clinically important.