AIDS TREATMENT NEWS No. 058 - June 3, 1988
John S. James
No placebo will be used. Instead there will be two doses, 30 mg and 150 mg, every two weeks.
There has been some controversy over whether 30 mg is enough; also, no one knows for sure how large a dose will prove safe for long-term use. We are hearing that when pneumocystis does occur in persons using aerosol pentamidine, it tends to be mild; there have been very few deaths from pneumocystis in such studies, even at the low 30 mg dose. In any case, and independent company will audit the charts of patients in this study, so that the trial can be stopped if the low dose turns out to be too small.
Other Options
Persons at risk for pneumocystis should know that there are other options--such as dapsone, or Septra--if they cannot obtain aerosol pentamidine. These are more likely to cause side effects, but seem to work well if patients can tolerate them. They are much less expensive. What is most important is that those at risk for pneumocystis should use some form of prophylaxis.
AIDS Treatment News has published several warnings about fansidar, another drug sometimes used for pneumocystis prophylaxis; it can cause serious or fatal reactions, and patients using it must get appropriate warnings from their physicians so that they will stop the drug and get medical help immediately if symptoms develop. Recently we have heard that fansidar is much more likely to cause problems if used by patients who are also taking AZT.
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