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Pyrimethamine alone as maintenance therapy for central nervous system toxoplasmosis in 38 patients with AIDS.
J Acquir Immune Defic Syndr. 1992; 5(2):137-42.JA

Abstract

We retrospectively assessed the efficacy of maintenance therapy with pyrimethamine alone in 38 patients with AIDS and central nervous system (CNS) toxoplasmosis. The diagnosis was based on clinical presentation and compatible CT scan abnormalities with subsequent response to therapy. Survival analysis was performed by the product limit method of Kaplan-Meier. Fourteen patients received maintenance therapy with 25 mg pyrimethamine per day (group 1), and 24 patients were treated with 50 mg per day (group 2). The median survival from initiation of maintenance therapy until death or end of the study for the entire study population was 32 weeks. Median survival in group 1 was 28 weeks, as compared with 36 weeks in group 2 (p = 0.34). Relapses occurred in 12 patients, six in group 1 and six in group 2. There was no significant difference in failure-free survival between the two treatment groups (p = 0.09). One patient in group 1 and two patients in group 2 experienced severe toxicity, requiring discontinuation of therapy. All three patients relapsed and died. Two patients in group 2 who stopped treatment on their own initiative also had relapses. Thus, all five patients who discontinued therapy had relapses. Five of 13 patients in group 1 and two of 20 patients in group 2 relapsed during continuous therapy with pyrimethamine (p = 0.13); these seven patients responded to reintroduction of combination therapy (n = 6) or treatment with 50 mg pyrimethamine per day (n = 1). The results of our retrospective analysis suggest that maintenance therapy with oral pyrimethamine, 50 mg per day, in AIDS patients with CNS toxoplasmosis is effective.

Authors+Show Affiliations

Department of Neurology, Academisch Medisch Centrum, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1732505

Citation

de Gans, J, et al. "Pyrimethamine Alone as Maintenance Therapy for Central Nervous System Toxoplasmosis in 38 Patients With AIDS." Journal of Acquired Immune Deficiency Syndromes, vol. 5, no. 2, 1992, pp. 137-42.
de Gans J, Portegies P, Reiss P, et al. Pyrimethamine alone as maintenance therapy for central nervous system toxoplasmosis in 38 patients with AIDS. J Acquir Immune Defic Syndr. 1992;5(2):137-42.
de Gans, J., Portegies, P., Reiss, P., Troost, D., van Gool, T., & Lange, J. M. (1992). Pyrimethamine alone as maintenance therapy for central nervous system toxoplasmosis in 38 patients with AIDS. Journal of Acquired Immune Deficiency Syndromes, 5(2), 137-42.
de Gans J, et al. Pyrimethamine Alone as Maintenance Therapy for Central Nervous System Toxoplasmosis in 38 Patients With AIDS. J Acquir Immune Defic Syndr. 1992;5(2):137-42. PubMed PMID: 1732505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pyrimethamine alone as maintenance therapy for central nervous system toxoplasmosis in 38 patients with AIDS. AU - de Gans,J, AU - Portegies,P, AU - Reiss,P, AU - Troost,D, AU - van Gool,T, AU - Lange,J M, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 137 EP - 42 JF - Journal of acquired immune deficiency syndromes JO - J. Acquir. Immune Defic. Syndr. VL - 5 IS - 2 N2 - We retrospectively assessed the efficacy of maintenance therapy with pyrimethamine alone in 38 patients with AIDS and central nervous system (CNS) toxoplasmosis. The diagnosis was based on clinical presentation and compatible CT scan abnormalities with subsequent response to therapy. Survival analysis was performed by the product limit method of Kaplan-Meier. Fourteen patients received maintenance therapy with 25 mg pyrimethamine per day (group 1), and 24 patients were treated with 50 mg per day (group 2). The median survival from initiation of maintenance therapy until death or end of the study for the entire study population was 32 weeks. Median survival in group 1 was 28 weeks, as compared with 36 weeks in group 2 (p = 0.34). Relapses occurred in 12 patients, six in group 1 and six in group 2. There was no significant difference in failure-free survival between the two treatment groups (p = 0.09). One patient in group 1 and two patients in group 2 experienced severe toxicity, requiring discontinuation of therapy. All three patients relapsed and died. Two patients in group 2 who stopped treatment on their own initiative also had relapses. Thus, all five patients who discontinued therapy had relapses. Five of 13 patients in group 1 and two of 20 patients in group 2 relapsed during continuous therapy with pyrimethamine (p = 0.13); these seven patients responded to reintroduction of combination therapy (n = 6) or treatment with 50 mg pyrimethamine per day (n = 1). The results of our retrospective analysis suggest that maintenance therapy with oral pyrimethamine, 50 mg per day, in AIDS patients with CNS toxoplasmosis is effective. SN - 0894-9255 UR - https://www.unboundmedicine.com/medline/citation/1732505/Pyrimethamine_alone_as_maintenance_therapy_for_central_nervous_system_toxoplasmosis_in_38_patients_with_AIDS_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=1732505.ui DB - PRIME DP - Unbound Medicine ER -