Assuntos
Humanos , Talidomida/administração & dosagem , Talidomida/efeitos adversos , Talidomida , Talidomida/história , Talidomida/farmacologia , Talidomida/provisão & distribuição , Talidomida/uso terapêutico , Legislação de Medicamentos , Medicamentos de Controle Especial , Hansenostáticos , Lúpus Eritematoso Sistêmico , Mieloma Múltiplo , Protocolos Clínicos , Doença CrônicaAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Mieloma Múltiplo/tratamento farmacológico , Talidomida/uso terapêutico , Idoso , Transplante de Células-Tronco Hematopoéticas , Humanos , Estudos Multicêntricos como Assunto , Mieloma Múltiplo/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Talidomida/provisão & distribuiçãoRESUMO
AIDS: AIDS Wasting Syndrome (AWS), a devastating consequence of HIV disease, is defined as involuntary loss of body mass and a disproportionate loss of muscle mass. Its exact mechanisms are unknown, but some of the side effects of drugs or opportunistic infections can increase the likelihood of developing AWS. Low testosterone levels are associated with AWS in both men and women, and testosterone replacement therapy is indicated. Other anabolic therapies are available, including serostim (growth hormone), but the cost is prohibitive. Nandrolone, Oxandrolone, and Megestrol Acetate are other medications that have some effectiveness in combating AWS. Thalidomide has shown promise in treating wasting and contact information is provided for a compassionate use program. The need for proper nutrition and exercise is also emphasized.^ieng
Assuntos
Anabolizantes/uso terapêutico , Estimulantes do Apetite/uso terapêutico , Síndrome de Emaciação por Infecção pelo HIV/dietoterapia , Síndrome de Emaciação por Infecção pelo HIV/tratamento farmacológico , Hormônio do Crescimento Humano/uso terapêutico , Testosterona/uso terapêutico , Infecções Oportunistas Relacionadas com a AIDS/complicações , Anabolizantes/efeitos adversos , Dronabinol/uso terapêutico , Exercício Físico , Feminino , Síndrome de Emaciação por Infecção pelo HIV/metabolismo , Hormônio do Crescimento Humano/economia , Humanos , Masculino , Acetato de Megestrol/uso terapêutico , Fenômenos Fisiológicos da Nutrição , Fatores Sexuais , Talidomida/provisão & distribuição , Talidomida/uso terapêuticoRESUMO
AIDS: Thalidomide shows a significant ability to eliminate painful mouth ulcers in HIV patients and is also effective in reversing wasting and clearing up severe diarrhea caused by microsporidiosis. However, the drug comes with several side effects. Side effects include peripheral neuropathy, neutropenia, sedation, rash, and a small but statistically significant rise in HIV viral loads. Many physicians are not using Thalidomide due to the publicity that was generated from the birth defects that it caused. Thalidomide is available free through a compassionate use program and through an Investigational New Drug (IND) protocol. Contact information is included for both of these programs.^ieng
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Fármacos Anti-HIV/uso terapêutico , Síndrome de Emaciação por Infecção pelo HIV/tratamento farmacológico , Microsporidiose/tratamento farmacológico , Estomatite Aftosa/tratamento farmacológico , Talidomida/uso terapêutico , Fármacos Anti-HIV/efeitos adversos , Fármacos Anti-HIV/provisão & distribuição , Feminino , Humanos , Masculino , Talidomida/efeitos adversos , Talidomida/provisão & distribuiçãoRESUMO
AIDS: Preliminary findings from a study on the effects of thalidomide on HIV-related wasting syndrome are encouraging. The study shows that at least half of the weight gained by participants was in the form of lean body mass. Side effects included declines in neutrophil counts and pain or tingling in the hands and/or feet. A 0.3 log increase in viral load and no decrease in TNF-alpha levels were also noted. Celgene, the manufacturer of thalidomide, has streamlined an expanded access program and fully covers the cost of the drug for people who qualify for the program. (A phone number is provided for more information.) Additionally, the company is studying the benefits of thalidomide treatment for oral and esophageal aphthous ulcers. Results from the use of three different doses following four weeks will be compared, after which patients will be randomly assigned to either a placebo or thalidomide to determine its ability to prevent a relapse. Because of thalidomide's connection to serious birth defects, it is important that men and women engaging in reproductive sex use precautions to prevent pregnancy.^ieng
Assuntos
Síndrome de Emaciação por Infecção pelo HIV/tratamento farmacológico , Talidomida/uso terapêutico , Ensaios Clínicos como Assunto , Aprovação de Drogas , Humanos , Úlceras Orais/tratamento farmacológico , Placebos , Gravidez , Talidomida/efeitos adversos , Talidomida/provisão & distribuição , Fator de Necrose Tumoral alfa/metabolismo , Estados Unidos , United States Food and Drug Administration , Carga Viral , Aumento de PesoRESUMO
AIDS: The Food and Drug Administration (FDA) has authorized thalidomide in an expanded-access program for AIDS-related wasting. The New Jersey program will randomize patients to either 50 or 200 mg doses. Response will be measured after four weeks; those failing the lower dose can switch to the higher dose at that time. Patients may continue therapy indefinitely. Treatment cost may be up to $1,000 per year. Physicians will need to obtain IRB approval to participate. Those who are excluded are pregnant women or those of childbearing age, those involved in a separate double-blind controlled trial of thalidomide which is still recruiting, and those with peripheral neuropathy or major blood chemistry abnormalities. For more information, call (800) 896-6766, or, after September 4th, call (800) 253-1596.^ieng
Assuntos
Síndrome de Imunodeficiência Adquirida/complicações , Caquexia/tratamento farmacológico , Imunossupressores/uso terapêutico , Seleção de Pacientes , Ensaios Clínicos Controlados Aleatórios como Assunto , Talidomida/uso terapêutico , Caquexia/etiologia , Custos e Análise de Custo , Feminino , Linhas Diretas , Humanos , Imunossupressores/economia , Imunossupressores/provisão & distribuição , New Jersey , Talidomida/economia , Talidomida/provisão & distribuiçãoRESUMO
AIDS: Descriptions and entry criteria for three expanded access programs for experimental drugs used in treating AIDS patients are provided. The programs involve use of Abbott Laboratories' protease inhibitor, ritonavir; Hoffman-La Roche's protease inhibitor, saquinavir; and Celgene Corporation's treatment for wasting, thalidomide.^ieng