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Randomized phase II trial of atovaquone with pyrimethamine or sulfadiazine for treatment of toxoplasmic encephalitis in patients with acquired immunodeficiency syndrome: ACTG 237/ANRS 039 study

  • AIDS Clinical Trials Group 237/Agence Nationale de Recherche sur le SIDA, Essai 039 Study Team
  • SUNY Downstate Health Sciences University
  • National Institutes of Health
  • Université Paris Cité
  • Stanford University
  • Harvard University
  • Departments of Medicine
  • Stony Brook University
  • New York University
  • Hôpital Saint-André
  • University of Miami
  • Hôpital Jean Verdier
  • Hopital Pasteur
  • Hôpital Hotel-Dieu
  • ANRS
  • Frontier Science & Technology Research Foundation
  • Indiana University Bloomington
  • University of Hawai'i at Mānoa
  • New York Presbyterian Hospital
  • Continuum Health Partners, Inc.
  • University of Cincinnati
  • GlaxoSmithKline
  • Abbott Laboratories

Research output: Contribution to journalArticlepeer-review

107 Scopus citations

Abstract

In this international, noncomparative, randomized phase II trial, we evaluated the effectiveness and tolerance of atovaquone suspension (1500 mg orally twice daily) plus either pyrimethamine (75 mg per day after a 200-mg loading dose) or sulfadiazine (1500 mg 4 times daily) as treatment for acute disease (for 6 weeks) and as maintenance therapy (for 42 weeks) for toxoplasmic encephalitis (TE) in patients infected with human immunodeficiency virus. Twenty-one (75%) of 28 patients receiving pyrimethamine (95% lower confidence interval [CI], 58%) and 9 (82%) of 11 patients receiving sulfadiazine (95% lower CI, 53%) responded to treatment for acute disease. Of 20 patients in the maintenance phase, only 1 experienced relapse. Eleven (28%) of 40 eligible patients discontinued treatment as a result of adverse events, 9 because of nausea and vomiting or intolerance of the taste of the atovaquone suspension. Although gastrointestinal side effects were frequent, atovaquone-containing regimens are otherwise well tolerated and safe and may be useful for patients intolerant of standard regimens for toxoplasmic encephalitis.

Original languageEnglish
Pages (from-to)1243-1250
Number of pages8
JournalClinical Infectious Diseases
Volume34
Issue number9
DOIs
StatePublished - May 1 2002

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