Treatment with letrazuril of refractory cryptosporidial diarrhea complicating AIDS.

Abstract

Thirty-five AIDS patients (mean CD4 count 44 x 10(6)/L) with chronic cryptosporidiosis were treated with letrazuril at an initial oral daily dose of 50 mg in an open-label Phase I prospective trial. Treatment was continued for > or = 10 days and for as long as there was a response. The majority of subjects (91%), had previously failed paromomycin treatment. At baseline, 74% of patients had moderate (five to nine bowel movements per day) to severe (> 10 bowel movements per day) diarrhea. Twenty-three subjects (66%) had a clinical response within a mean of 1.7 weeks of treatment initiation. Twenty-two patients had a partial response (> 50% reduction in bowel movements per day for > or = 1 week), one patient had a complete response (two or fewer bowel movements per day). Of the responders, 15 (65%) had a clinical relapse with worsening diarrhea at an average of 1.2 months following initiation of letrazuril. The other eight (35%) had had symptom control for an average of 2.9 months from initiation of letrazuril to the latest follow-up. Microbiologic eradication was demonstrated in 10 (40%) of 25 patients with follow-up stool examinations. Seven patients (20%) experienced a rash, all within 1 week of starting the drug, and resolved in all patients when the drug was discontinued. In conclusion, severely immunocompromised AIDS patients with refractory cryptosporidiosis may show a modest, short-lived response to letrazuril. Microbiologic response is variable and relapse high. Rash is a major limiting side effect of the drug.

• Authors: M Loeb, C Walach, J Phillips, I Fong, I Salit, A Rachlis, S Walmsley
• Journal: Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association (J Acquir Immune Defic Syndr Hum Retrovirol) Vol. 10 Issue 1 Pg. 48-53 (Sep 01 1995) ISSN: 1077-9450 [Print] United States
• PMID: 7648284 (Publication Type: Clinical Trial, Clinical Trial, Phase I, Journal Article)

Chemical References

• Acetonitriles
• Coccidiostats
• Triazines
• letrazuril

Topics

• Acetonitriles (adverse effects, therapeutic use)
• Acquired Immunodeficiency Syndrome (complications)
• Adult
• Animals
• Coccidiostats (adverse effects, therapeutic use)
• Cryptosporidiosis (drug therapy)
• Demography
• Diarrhea (drug therapy)
• Female
• Humans
• Male
• Middle Aged
• Treatment Outcome
• Triazines (adverse effects, therapeutic use)