Cidofovir for Cytomegalovirus Retinitis

Letters15 September 1997Cidofovir for Cytomegalovirus RetinitisStephen Kravcik, MD, FRCPCStephen Kravcik, MD, FRCPCOttawa General Hospital; Ottawa, Ontario K1H 8L6, CanadaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-6-199709150-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The demonstration of the effectiveness of cidofovir to treat cytomegalovirus (CMV) retinitis adds a welcome third drug to the list of anti-CMV therapies. However, it is most disturbing to find that the two clinical studies of this compound [1, 2] compared it with no treatment (“deferred therapy”).There is no doubt that the natural history of untreated CMV retinitis is one of relentless progression and that ganciclovir [3] and foscarnet [4] are both effective. Therefore, the withholding of proven therapy (even with close follow-up) in the context of a clinical trial to demonstrate the effectiveness of cidofovir ...References1. Lalezari JP, Stagg RJ, Kuppermann BD, Holland GN, Kramer F, Ives DV, et al. Intravenous cidofovir for peripheral cytomegalovirus retinitis in patients with AIDS. A randomized, controlled trial. Ann Intern Med. 1997; 126:257-63. Google Scholar2. Studies of Ocular Complications of AIDS Research Group in Collaboration with the AIDS Clinical Trial Group. Parenteral cidofovir for cytomegalovirus retinitis in patients with AIDS: the HPMPC Peripheral Cytomegalovirus Retinitis Trial. A randomized, controlled trial. Ann Intern Med. 1997; 126:264-74. Google Scholar3. Collaborative DHPG Study Group. Treatment of serious cytomegalovirus infections with 9-(1,3-dihydroxy-2-propoxymethyl) guanine in patients with AIDS and other immunodeficiencies. N Engl J Med. 1986; 314:801-5. Google Scholar4. Studies of Ocular Complications of AIDS Research Group, in collaboration with the AIDS Clinical Trial Group. Mortality in patients with the acquired immunodeficiency syndrome treated with either ganciclovir or foscarnet for cytomegalovirus retinitis. N Engl J Med. 1992; 326:213-20. Google Scholar Author, Article, and Disclosure InformationAffiliations: Ottawa General Hospital; Ottawa, Ontario K1H 8L6, Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByBeyond Urban Penalty and Urban Sprawl: Back to Living Conditions as the Focus of Urban Health 15 September 1997Volume 127, Issue 6Page: 490KeywordsClinical trialsCryptococcal meningitisCytomegalovirus infectionDrug therapyOpportunistic infectionsPneumocystis carinii pneumoniaRetinitis Issue Published: 15 September 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...