Faculty Bibliography
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3
MSL-109 adjuvant therapy for cytomegalovirus retinitis in patients with acquired immunodeficiency in syndrome - The monoclonal antibody cytomegalovirus retinitis trial
Objective: To evaluate the the efficacy and safety of an intravenous human monoclonal antibody to cytomegalovirus (CMV), MSL-109, as adjuvant treatment for CMV retinitis. Methods: Two hundred nine patients with acquired immunodeficiency syndrome and active CMV retinitis were enrolled in a multicenter, phase 2/3, randomized, placebo-controlled clinical trial. Patients received adjuvant treatment with MSL-109, 60 mg intravenously every 2 weeks, or placebo. Randomization was stratified on the basis of whether patients had untreated or relapsed retinitis. Primary drug therapy for CMV retinitis was determined by the treating physician. Results: The rates of retinitis progression, as evaluated in a masked fashion, were 3.04/person-year in the MSL-109-treated group and 3.05/person-year in the placebo-treated group (P=.98; Wald test); the median times to progression were 67 days in the MSL-109-treated group and 65 days in the placebo-treated group. No differences between the 2 groups were noted in the rates of increase in retinal area involved by CMV, visual field loss, or visual acuity outcomes. The mortality rate in the MSL-109-treated group was 0.68/person-year, and in the placebo-treated group, 0.31/person-year (P=.01). The mortality difference was not explained by differences in baseline variables or in concurrent antiretroviral therapy. Among patients with newly diagnosed retinitis, mortality rates were similar (MSL-109, 0.41/person-year; placebo, 0.42/person-year; P=.95), whereas among patients with relapsed retinitis the MSL-109-treated group had a greater mortality rate (MSL-109, 0.83/person-year, placebo, 0.24/person-year; P=.003). However, the mortality rate in the placebo-treated patients with relapsed CMV retinitis was lower than that in the placebo-treated patients with newly diagnosed CMV retinitis and lower than that in other trials of patients with relapsed CMV retinitis. Conclusions: Intravenous MSL-109, 60 mg every 2 weeks, appeared to be ineffective adjuvant therapy for CMV retinitis. The mortality rate was higher in the MSL-109-treated group, but the reasons for this difference remain uncertain
ISI:A1997YK25100005
ISSN: 0003-9950
CID: 53126
Exchange transfusion in sickling maculopathy [Case Report]
Unilateral macular infarction occurred in a 23-year-old black man with sickle cell hemoglobinopathy (SS), who was already receiving oxygen and hydration treatment for a painful crisis. Visual acuity of 20/200-1 in the affected eye did not improve with 36 hours of 'conservative' treatment. Fifteen hours after an exchange transfusion, however, visual acuity started to improve. By 36 hours after transfusion, a visual acuity of 20/40 was achieved, with the gradual return over 8 weeks to 20/20. This case provides strong circumstantial support for the effectiveness of exchange transfusion in sickling maculopathy
PMID: 3835617
ISSN: 0275-004x
CID: 26011
Physical properties of vitamin E oil and silicone oil
A comparison of the physical properties of vitamin E oil and silicone oil is made. The parameters measured include: viscosity, fluid density, refractive index and wetting characteristics of the water/liquid interface. These properties showed remarkable similarities between vitamin E oil and silicone oil
PMID: 4070808
ISSN: 0275-004x
CID: 23094
