TY - JOUR
T1 - Low-dose zalcitabine-related toxic neuropathy
T2 - Frequency, natural history, and risk factors
AU - Blum, A. S.
AU - Dal Pan, G. J.
AU - Feinberg, J.
AU - Raines, C.
AU - Mayjo, K.
AU - Cornblath, D. R.
AU - McArthur, J. C.
PY - 1996/4
Y1 - 1996/4
N2 - We studied the features and frequency of sensory neuropathy among 79 HIV- 1-infected individuals participating in a multicenter clinical trial of zalcitabine (2'3'-dideoxycytidine, or ddC) antiretroviral therapy. The trial compared zalcitabine monotherapy (2.25 mg/day) versus combination therapy (2.25 mg/day ddC) with zidovudine (ZDV, formerly AZT) versus monotherapy with ZDV alone. Neuropathy developed in 34% of ddC recipients but in only 4% of comparable patients treated with ZDV alone-a 7.9-fold increase in the attack rate of neuropathy. Using risk factor analysis, we found that diabetes mellitus was significantly associated with the development of toxic neuropathy (p = 0.02), and weight loss may contribute to its appearance. Like HIV-associated sensory neuropathy, ddC-related toxic neuropathy is a predominantly sensory, length-dependent, symmetric, painful neuropathy. Dose reduction lessened the severity of symptoms, although objective signs of neuropathy persisted. Patients with subclinical neuropathies or significant neuropathy risks such as diabetes may be poor candidates for ddC therapy.
AB - We studied the features and frequency of sensory neuropathy among 79 HIV- 1-infected individuals participating in a multicenter clinical trial of zalcitabine (2'3'-dideoxycytidine, or ddC) antiretroviral therapy. The trial compared zalcitabine monotherapy (2.25 mg/day) versus combination therapy (2.25 mg/day ddC) with zidovudine (ZDV, formerly AZT) versus monotherapy with ZDV alone. Neuropathy developed in 34% of ddC recipients but in only 4% of comparable patients treated with ZDV alone-a 7.9-fold increase in the attack rate of neuropathy. Using risk factor analysis, we found that diabetes mellitus was significantly associated with the development of toxic neuropathy (p = 0.02), and weight loss may contribute to its appearance. Like HIV-associated sensory neuropathy, ddC-related toxic neuropathy is a predominantly sensory, length-dependent, symmetric, painful neuropathy. Dose reduction lessened the severity of symptoms, although objective signs of neuropathy persisted. Patients with subclinical neuropathies or significant neuropathy risks such as diabetes may be poor candidates for ddC therapy.
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U2 - 10.1212/WNL.46.4.999
DO - 10.1212/WNL.46.4.999
M3 - Article
C2 - 8780079
AN - SCOPUS:9244235985
SN - 0028-3878
VL - 46
SP - 999
EP - 1003
JO - Neurology
JF - Neurology
IS - 4
ER -