Important note: Information in this article was accurate in November 2001. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, November 19 & 26, 2001
Michael Greer, Senior Medical Writer
NewsRx -- Prednisone should not be used to treat rashes induced by the HIV reverse transcriptase inhibitor nevirapine, researchers in Spain warn.
"Rash is the most frequent adverse event associated with nevirapine," according to Jose M. Miro, Hospital del Mar, Barcelona, and colleagues in a multicenter study. "The use of prednisone has been controversial in this setting."
The controversy was for good reason - prednisone actually appears to worsen nevirapine-induced rash, according to Miro and coworkers.
They evaluated the safety and efficacy of prednisone in 75 nevirapine-treated patients, 39 of whom were also treated with the anti-inflammatory immunosuppressant. Surprisingly, they found that study participants who received prednisone were almost four times more likely to develop rashes than those given a placebo drug.
Moreover, patients treated with prednisone were more likely to develop rashes severe enough to force cessation of nevirapine therapy although the increased risk was not statistically significant. Miro and associates also saw a trend toward an increased chance of therapy-ending complications other than rashes in patients who took prednisone with nevirapine.
Prednisone did not delay or hasten the onset of rash, which occurred a median of 16 days after the start of nevirapine therapy (Failure of a short-term prednisone regimen to prevent nevirapine-associated rash: A double-blind placebo- controlled trial: The GESIDA 09/99 study, J Acquir Immune Defic Syndr 2001 Sep 1;28(1):14-18.
"Short-term prednisone administration does not prevent nevirapine rash, but might even increase its incidence," Miro and coauthors concluded.
The corresponding author for this report is Jose M. Miro, Hospital del Mar, Dept. of Internal Medicine-Infectious Diseases, Paseo Maritimo 25-29, Barcelona 08003, Spain.
A search at www.NewsRx.net using the term "AIDS and HIV therapy" yielded 872 articles in 20 specialized reports.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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