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Foscarnet sodium.

J R Minor1, J K Baltz

  • 1Pharmacy Department, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892.

DICP : the Annals of Pharmacotherapy
|January 1, 1991
PubMed
Summary
This summary is machine-generated.

Foscarnet offers an alternative treatment for cytomegalovirus (CMV) retinitis in AIDS patients when ganciclovir causes myelosuppression. This antiviral agent shows efficacy and suppresses HIV replication, though renal impairment is a concern.

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Area of Science:

  • Virology
  • Immunology
  • Ophthalmology

Background:

  • Cytomegalovirus (CMV) is an opportunistic pathogen causing severe disease in immunocompromised individuals, particularly CMV retinitis in AIDS patients.
  • Ganciclovir is the primary treatment for CMV retinitis but often causes dose-limiting myelosuppression, especially when combined with other AIDS medications.
  • Alternative treatments are needed for CMV retinitis, considering the limitations of current therapies.

Purpose of the Study:

  • To evaluate foscarnet sodium as an alternative treatment for cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome (AIDS).
  • To compare the efficacy and toxicity profile of foscarnet with ganciclovir for CMV retinitis management.

Main Methods:

  • Intravenous foscarnet therapy was administered to patients with CMV retinitis.

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  • Initial daily doses ranged from 180-230 mg/kg/d in divided infusions, followed by maintenance regimens of 60-90 mg/kg/d as single daily infusions.
  • Patient outcomes, including viral load suppression and adverse events, were monitored.

    • Main Results:

    • Foscarnet demonstrated favorable results in treating CMV retinitis.
    • A significant advantage of foscarnet is its lack of major myelosuppressive toxicity compared to ganciclovir.
    • Foscarnet also exhibited activity in suppressing human immunodeficiency virus type 1 (HIV-1) replication.

    Conclusions:

    • Foscarnet sodium is a potentially safe and effective alternative agent for managing CMV infection, particularly CMV retinitis in AIDS patients.
    • Its efficacy against CMV and HIV, coupled with minimal myelosuppression, makes it a valuable option when ganciclovir is contraindicated or poorly tolerated.
    • Potential renal impairment necessitates careful monitoring during foscarnet therapy, and long-term treatment may be required to prevent relapse.