A DOSE-RANGING STUDY OF DAILY MAINTENANCE INTRAVENOUS FOSCARNET THERAPY FOR CYTOMEGALOVIRUS RETINITIS IN AIDS

Thirty-two patients with AIDS and previously untreated cytomegalovirus retinitis completed an induction course of foscarnet, 60 mg/kg every 8 h for 14 days, had retinitis stabilize, and were then randomly assig ned to receive foscarnet maintenance as either a 90- or 120-mg/kg/day infusion administered over 2 h. Median survival was 157 and 336 days f or the 90- and 120-mg/kg/day groups, respectively (P < .001). In an in dependent, masked analysis of retinal photographs, median time to prog ression of retinitis was 31 versus 95 days (P = .13). Daily intravenou s foscarnet at a dose of 120 mg/kg (adjusted for renal function) resul ted in significantly longer survival and tended to increase time to re tinitis progression compared to the standard 90-mg/kg/day maintenance dose. Although a substantial increase in the risk of serious toxicity at the 120-mg/kg/day dose was not observed, the small sample size in t his trial limited the power to detect differences that might be clinic ally important.