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Dose-related difference in progression rates of cytomegalovirus retinopathy during foscarnet maintenance therapy . AIDS Clinical Trials Group Protocol 915 Team . PURPOSE A previous dose-ranging study of foscarnet maintenance therapy for cytomegalovirus retinopathy showed a positive relationship between dose and survival but could not confirm a relationship between dose and time to first progression . This retrospective analysis of data from that study was undertaken to determine whether there was a relationship between dose and progression rates , which reflects the amount of retina destroyed when progression occurs . METHODS Patients were randomly given one of two foscarnet maintenance therapy doses ( 90 mg/kg of body weight/day [ FOS-90 group ] or 120 mg/kg of body weight/day [ FOS-120 group ] after induction therapy . Using baseline and follow-up photographs and pre-established definitions and methodology in a masked analysis , posterior progression rates and foveal proximity rates for individual lesions , selected by prospectively defined criteria , were calculated in each patient . Rates were compared between groups . RESULTS The following median rates were greater for the FOS-90 group ( N = 8 ) than for the FOS-120 group ( N = 10 ) : greatest maximum rate at which lesions enlarged in a posterior direction ( 43.5 vs 12.5 microns/day ; P = .002 ) ; posterior progression rate for lesions closest to the fovea ( 42.8 vs 5.5 microns/day ; P = .010 ) ; and maximum foveal proximity rate for either eye ( 32.3 vs 3.4 microns/day ; P = .031 ) . CONCLUSION Patients receiving higher doses of foscarnet have slower rates of progression and therefore less retinal tissue damage during maintenance therapy . A foscarnet maintenance therapy dose of 120 mg/kg of body weight/day instead of 90 mg/kg of body weight/day may help to preserve vision in patients with cytomegalovirus retinopathy .
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Intervention_Pharmacological
foscarnet maintenance therapy .
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Intervention_Pharmacological
foscarnet maintenance therapy
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Intervention_Pharmacological
two foscarnet maintenance therapy doses
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Intervention_Pharmacological
FOS-90
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Intervention_Pharmacological
FOS-90
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Intervention_Pharmacological
foscarnet
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Intervention_Pharmacological
foscarnet
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Outcome_Physical
lesions
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Outcome_Physical
posterior progression rate for lesions
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Outcome_Physical
maximum foveal proximity rate for either eye
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Participant_Condition
cytomegalovirus retinopathy