CMV Retinitis: New Trial of HPMPC As First Treatment

HPMPC (also called GS-0504) is more active against CMV than
either ganciclovir or foscarnet; early human trials have
shown good results in clearing CMV from urine and semen.
Unfortunately, HPMPC also causes kidney toxicity, which can
be reduced by adjusting the dosage schedule, and by use of
probenecid, a drug which reduces the absorption of HPMPC by
the kidneys. The key question now is whether the toxicity can
be controlled enough for the drug to be generally used as a
treatment.

The new trial, at several sites in the U.S. and one in the
U.K., will test the drug on patients who have CMV retinitis
which is not immediately sight threatening. Volunteers will
be randomly assigned either to immediate treatment, or to
deferred treatment which will begin if CMV progression is
seen. They will be examined every two weeks. The drug is
given infrequently -- only once per week for the first two
weeks, then only once every two weeks.

To be eligible, volunteers must have newly diagnosed CMV
retinitis, which has not yet been treated with ganciclovir or
foscarnet. They will be tested for kidney function, and must
not have abnormal lab values.

This trial will take place in San Francisco, Los Angeles (2
sites), Boston, Rochester, San Antonio, Chapel Hill, Irvine
(California), and at St. Stephen's Clinic, Moorfields Eye
Hospital, in London. For more information, including how to
contact the sites, call Jay Lalezari, M.D., at Mt. Zion
Medical Center, 415/476-6356.