title: Safety of alternating ganciclovir and foscarnet maintenance therapy in human immunodeficiency virus (HIV)-related cytomegalovirus infections. An open-labeled pilot study.
abstract: In the treatment of cytomegalovirus (CMV) disease in patients with AIDS, a life-long suppression therapy following an induction therapy consisting of ganciclovir or foscarnet is essential. Due to drug-related toxicities, anti-CMV therapy frequently has to be discontinued. To determine whether toxicities and side effects may be reduced with an alternating combination therapy consisting of ganciclovir and foscarnet (ganciclovir: 5 mg/kg every other day; foscarnet: 120 mg/kg every other day), 10 AIDS patients with CMV disease received this maintenance therapy for a median time of 18.5 weeks (5-51 weeks). Side effects were reported from 5 patients (nausea 5, malaise/fatigue 2, penile ulcers 1). Hematological or renal toxicities were mild, 1-week discontinuation of therapy due to neutropenia was necessary in 1 patient. Progression of CMV disease was observed in 3 patients at 2, 6, and 30 weeks of maintenance therapy. Median relapse-free interval for all patients was 105 days. We conclude that combination therapy with ganciclovir and foscarnet can be used safely for induction and maintenance therapy. Therefore, this regimen should be assessed in further trials to evaluate safety, efficacy, and the development of resistance in comparison to ganciclovir or foscarnet monotherapy.
authors.affiliation: Department of Medicine, Rudolf Virchow University Hospital, Freie Universität Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Peters
authors.forename: D
authors.initials: D
authors.lastname: Schürmann
authors.forename: F
authors.initials: F
authors.lastname: Bergmann
authors.forename: T
authors.initials: T
authors.lastname: Grünewald
authors.forename: H
authors.initials: H
authors.lastname: Timm
authors.forename: H D
authors.initials: HD
authors.lastname: Pohle
authors.forename: B
authors.initials: B
authors.lastname: Ruf
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D017245:Foscarnet / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D015774:Ganciclovir / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects
chemical_list: D017245:Foscarnet; D015774:Ganciclovir