(ATDN) Prevention and Treatment Studies for CMV Open

(ATDN) Prevention and Treatment Studies for CMV Open

Treatment Review #17 - March 1995

CMV disease is caused by a herpesvirus called cytomegalovirus (CMV). When it infects the eyes, it's called CMV retinitis. CMV can also infect other parts of the body. Ganciclovir and foscarnet are the approved drugs for treating CMV disease. Ganciclovir is also called Cytovene or DHPG, and foscarnet is called Foscavir. Both drugs are given by intravenous infusion through a permanent catheter that's placed in your chest. Once you have CMV disease you have to continue treatment every day. This is called maintenance therapy. The IV infusions are taken twice a day.

Although IV infusion is still necessary for the first part of treatment (called induction therapy), a recently approved pill form of ganciclovir is now available for maintenance therapy. Maintenance therapy starts once the active disease is under control. Oral ganciclovir is taken with food, three or six times a day. Intravenous infusions may no longer be needed.

Studies comparing the capsule to the IV form of the drug for treatment showed that the IV form was a little better. The major side effects of both forms are blood disorders. The most common side effects experienced by those taking the capsules were diarrhea, fever, leukopenia, and nausea.

Recent studies show that oral ganciclovir can prevent or delay CMV disease in people with low T4 cell counts. Taking the capsules for prevention may reduce cases of CMV disease by one-half. Because of the side effects, people also had to take G-CSF and erythropoietin, which stimulate growth of new blood cells, more often than study participants who got placebo.

Studies for prevention and treatment of CMV are ongoing. Oral ganciclovir for prevention use is now available through an expanded access program. Your doctor will have to call the company to register, and then fill out certain forms so the company can collect data on how well this drug works for prevention.

A study comparing different treatments (IV ganciclovir, an eye implant with oral ganciclovir, or an eye implant alone) is also looking for people. The implant is also available from the drug company through a compassionate use program if you are unable to take other treatments. A study of foscarnet for the treatment of CMV colitis is enrolling. CMV colitis is CMV infection in the upper or lower gastrointestinal tract.

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This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1995. AEGIS.