Adverse reactions to thalidomide in patients infected with human immunodeficiency virus

被引:35
作者
Haslett, P [1 ]
Tramontana, J [1 ]
Burroughs, M [1 ]
Hempstead, M [1 ]
Kaplan, G [1 ]
机构
[1] ROCKEFELLER UNIV,CELLULAR PHYSIOL & IMMUNOL LAB,NEW YORK,NY 10021
关键词
D O I
10.1086/513665
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Thalidomide is emerging as a useful agent in the management of several complications of disease due to human immunodeficiency virus (HIV). We conducted three prospective studies of 56 HIV-infected patients who were treated with thalidomide for 14-21 days; 24 (43%) of these patients discontinued therapy owing to adverse reactions. Cutaneous and/or febrile reactions were the most frequent toxicities, arising in 20 (36%) of the patients. These reactions occurred after a mean interval (+/-SD) of 10 +/- 3 days and were associated with significantly lower CD4 T lymphocyte counts in reactors than in nonreactors (median count, 52.5/mm(3) vs. 242 cells/mm(3), respectively; P =.009). Four of four rechallenged patients experienced accelerated hypersensitivity; hypotension occurred in one case. Although sedation was an almost universal side effect among the patients, it was moderate or severe in only seven (13%); constipation was moderate or severe in five (9%) of the patients. Severe neuropathic symptoms and mood changes were each noted in two (4%) of the 56 patients, We conclude that the increasing use of thalidomide to treat HIV-infected patients must be accompanied by recognition of the drug's increased potential for toxicity in this population.
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页码:1223 / 1227
页数:5
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