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Multicenter clinical trial of atovaquone (ATQ) for salvage treatment and suppression of toxoplasmic encephalitis (TE). The ATQ/TE Study Group.


Int Conf AIDS. 1993 Jun 6-11;9(1):377 (abstract no. PO-B10-1453). Unique

OBJECTIVE: To assess the efficacy, safety and tolerance of ATQ for salvage therapy of TE. METHODS: 93 AIDS patients with presumptive or biopsy-proven TE were treated with 750mg ATQ qid as salvage therapy in an open, noncomparative clinical trial. Clinical and neuroradiological (CT or MRI) assessments were made to assess response. Patients were followed until death. The relationship between ATQ plasma conc. and survival was tested Kaplan-Meier Product-Limit Method). RESULTS: TABULAR DATA, SEE ABSTRACT VOLUME. After six weeks of therapy, 88%, 63% and 54% were clinically stable or improved, and 68%, 50% and 38% were radiologically stable or improved, with ATQ plasma conc. of > 13 micrograms/ml, 7-13 micrograms/ml and < 7 micrograms/ml, respectively. Clinical improvement correlated with reduction in lesion size. ATQ was generally well-tolerated. Of note, there was only 1 case of Pneumocystis carinii pneumonia in 64 patients without PCP prophylaxis (mean time on ATQ = 124 days). CONCLUSION: There is an ATQ plasma conc.-response and survival relationship. Salvage treatment of TE patients with ATQ is associated with clinical and radiological improvement and prolonged survival.

*Antiprotozoal Agents/THERAPEUTIC USE *AIDS-Related Opportunistic Infections/DRUG THERAPY *Encephalitis/DRUG THERAPY *Naphthoquinones/THERAPEUTIC USE *Toxoplasmosis, Cerebral/DRUG THERAPY


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