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M94A0160.TXT
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1994-10-01
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Document 0160
DOCN M94A0160
TI A phase II study of effect of addition of trichosanthin to zidovudine in
patients with HIV disease and failing antiretroviral agents.
DT 9412
AU Byers VS; Levin AS; Malvino A; Waites L; Robins RA; Baldwin RW;
Immunology, Inc., San Francisco, California 94108.
SO AIDS Res Hum Retroviruses. 1994 Apr;10(4):413-20. Unique Identifier :
AIDSLINE MED/94347466
AB Patients infected with HIV, including those with AIDS-related complex
and AIDS, and failing treatment with antiretroviral agents such as
zidovudine, have been evaluated following addition of trichosanthin to
the antiretroviral agent regimen. This ribosomal inhibitory protein is
specifically cytotoxic for HIV-infected macrophages and lymphocytes.
Ninety-three patients were treated with trichosanthin, using a schedule
of weekly, then monthly, intravenous injections of 1.2 mg of drug in
combination with antiretroviral agents, usually zidovudine. Side effects
included myalgias, fevers, mild elevation in liver function tests, and
mild-moderate anaphylactic reactions, which respond well to therapy with
steroids and/or benedryl. Reversible mental status changes were noted in
two patients, both receiving concomitant therapy with ddI. Clinical
responses to trichosanthin treatment were monitored primarily by changes
in laboratory parameters, particularly levels of CD4+ T lymphocytes. In
the total population evaluated for efficacy (85 patients) there was a
significant increase in CD4+ cell levels after initiation of
trichosanthin therapy. A second analysis performed on 72 patients
measured the rate of change of CD4+ cells during therapy, using an area
under the curve analysis. During therapy there was a median increase of
1.2 cells/mm3/month. In patients in the top 25th percentile, this
increase was greater than 8.4 cells/mm3/month. In 59 of the 72 patients,
responses could also be monitored by comparing the rate of loss of CD4+
cell levels on antiretroviral agents (zidovudine or ddI) alone, during
the year prior to initiation of trichosanthin, to the rate of change
when trichosanthin was added to the treatment regimen. During the period
before trichosanthin treatment (311 +/- 11.7 days) the median loss of
CD4+ cells was 6.91 cells/mm3/month. Addition of trichosanthin to the
treatment regimen resulted in a median gain of 1.1 CD4+ cells/mm3/month.
DE Adolescence Adult Aged Didanosine/ADMINISTRATION & DOSAGE Drug
Therapy, Combination Female Human HIV Infections/BLOOD/*DRUG
THERAPY/IMMUNOLOGY Leukocyte Count Liver/DRUG EFFECTS Male Middle
Age Trichosanthin/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS T4
Lymphocytes Zidovudine/*ADMINISTRATION & DOSAGE CLINICAL TRIAL
CLINICAL TRIAL, PHASE II JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).