Dieterich D T, Poles M A, Lew E A, Mendez P E, Murphy R, Addessi A, Holbrook J T, Naughton K, Friedberg D N
New York University Medical Center, New York.
J Infect Dis. 1993 May;167(5):1184-8. doi: 10.1093/infdis/167.5.1184.
Ten patients with AIDS and progressive cytomegalovirus disease were treated with ganciclovir and foscarnet concurrently. The patients had received ganciclovir and foscarnet monotherapy a median of 330 days before receiving combination therapy for a median of 80 days. Nine of the 10 patients responded to the combination. No electrolyte abnormalities were noted during combination therapy, but rates of neutropenia (relative rate, combination vs. ganciclovir, 1.99; P = .229) and thrombocytopenia (relative rate, combination vs. ganciclovir, 1.53; P = .616) were higher with combination therapy than with either drug alone. The relative rate of anemia was significantly increased with combination therapy compared with monotherapy (relative rate, combination vs. ganciclovir, 2.69; P = .025). These data suggest that combination ganciclovir and foscarnet therapy after failure of either alone appears to be as effective as standard therapy with single agents. The rate of anemia with combination therapy was significantly greater than either agent alone, but no significant difference was noted among the other parameters of toxicity studied.
10例患有艾滋病和进行性巨细胞病毒病的患者同时接受了更昔洛韦和膦甲酸钠治疗。这些患者在接受联合治疗（中位时间80天）之前，接受更昔洛韦和膦甲酸钠单药治疗的中位时间为330天。10例患者中有9例对联合治疗有反应。联合治疗期间未发现电解质异常，但联合治疗时中性粒细胞减少（相对率，联合治疗与更昔洛韦相比，1.99；P = 0.229）和血小板减少（相对率，联合治疗与更昔洛韦相比，1.53；P = 0.616）的发生率高于单药治疗。与单药治疗相比，联合治疗时贫血的相对率显著增加（相对率，联合治疗与更昔洛韦相比，2.69；P = 0.025）。这些数据表明，在单药治疗失败后，更昔洛韦和膦甲酸钠联合治疗似乎与单药标准治疗一样有效。联合治疗时贫血的发生率显著高于单药治疗，但在所研究的其他毒性参数中未发现显著差异。
