Article: PDF OnlyFoscarnet Induction Therapy for Cytomegalovirus Retinitis in AIDS Comparison of Twice-Daily and Three-Times-Daily RegimensKatlama, Christine; Dohin, Elisabeth; Caumes, Eric*; Cochereau-Massin, I.; Brancon, Christiane*; Robinet, Martin; Rogeaux, Olivier†; Dahan, Robert; Gentilini, MarcAuthor Information Département de Maladies Infectieuses et Tropicales *Service d'Ophtalmologie, Hôpital de la Pitté-Salpêtrière, Paris †Astra France, Nanterre, France Journal of Acquired Immune Deficiency Syndromes: Volume 5 - Issue - p S18-24 Free Abstract We have evaluated the effects of induction therapy with foscarnet 100 mg/kg b.i.d. via i.v. infusion in 60 AIDS patients with cytomegalovirus (CMV) retinitis and compared the findings with those in 37 such patients receiving a foscarnet induction regimen of 60 mg/kg t.i.d. via i.v. infusion. Induction therapy was given for at least 3 weeks, with the treatment period being extended in cases of slow resolution of retinitis. There was no significant difference between response rates in the two groups, with ophthalmologic response being observed in 52 (96%) of 54 evaluable b.i.d. patients and 33 (97%) of 34 evaluable t.i.d. patients over mean durations of therapy of 26 and 27 days, respectively: complete and partial responses were observed in 91 and 6%, respectively, of b.i.d. patients and 85 and 12%, respectively, of t.i.d. patients. Foscarnet was discontinued because of adverse events in 3 (3%) of 97 patients, with treatment being stopped in 2 patients because of renal insufficiency and in 1 patient because of an acute neurologic disorder. Serum creatinine concentrations increased significantly in both the b.i.d. group (from 82 to 98 μmol/L, p < 0.01) and the t.i.d. group (from 73 to 122 μmol/L. p < 0.001), with the difference between increases not being statistically significant. Serum creatinine concentrations > 200 μmol/L were observed in two b.i.d. patients and four t.i.d. patients; in four cases, concomitant medications or conditions contributed to renal impairment. Hypocalcemia of < 1.75 mmol/L occurred in 18% of b.i.d. patients and 28% of t.i.d. patients during treatment (p = 0.03). Six b.i.d. patients and one t.i.d. patient experienced paresthesia and muscle twitching (p = 0.02). Penile ulceration was observed in 17% of b.i.d. patients and in none of the t.i.d. patients. Overall, nausea or vomiting occurred in 10% of patients. Our findings suggest that foscarnet 100 mg/kg b.i.d. is safe and effective as an induction regimen in AIDS patients with CMV retinitis. Such a regimen would enhance the convenience of foscarnet therapy, particularly in the home care setting. © Lippincott-Raven Publishers.