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Letters |15 September 1997

Cidofovir for Cytomegalovirus Retinitis

Stephen Kravcik, MD, FRCPC

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  • Ottawa General Hospital; Ottawa, Ontario K1H 8L6, Canada
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TO THE EDITOR:
The demonstration of the effectiveness of cidofovir to treat cytomegalovirus (CMV) retinitis adds a welcome third drug to the list of anti-CMV therapies. However, it is most disturbing to find that the two clinical studies of this compound [1, 2] compared it with no treatment (“deferred therapy”).
There is no doubt that the natural history of untreated CMV retinitis is one of relentless progression and that ganciclovir [3] and foscarnet [4] are both effective. Therefore, the withholding of proven therapy (even with close follow-up) in the context of a clinical trial to demonstrate the effectiveness of cidofovir is unacceptable. The rationalization that only patients with peripheral retinitis were enrolled is irrelevant and of questionable prudence because 4 of 23 patients in the no-treatment group developed sight-threatening retinitis and another patient developed extraocular CMV infection.
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Kravcik S. Cidofovir for Cytomegalovirus Retinitis. Ann Intern Med. ;127:490. doi: 10.7326/0003-4819-127-6-199709150-00015

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Published: Ann Intern Med. 1997;127(6):490.

DOI: 10.7326/0003-4819-127-6-199709150-00015

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