2′,3′-Dideoxycytidine (ddC) toxic neuropathy: A study of 52 patients

A. R. Berger, Joseph C. Arezzo, H. H. Schaumburg, G. Skowron, T. Merigan, S. Bozzette, D. Richman, W. Soo

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Abstract

We administered the antiviral agent 2′,3′-dideoxycytidine (ddC) to HIV-infected patients with either ARC or AIDS as part of the AIDS Clinical Treatment Group protocol 012 and serially evaluated them with neuropathic symptom questionnaires, neurologic examinations, nerve conduction studies, and quantitative sensory testing (QST). All patients treated with high-dose ddC (0.06 and 0.03 mg/kg every 4 hours) developed a painful, predominantly sensory peripheral neuropathy, with a mean onset of 7.7 weeks, which reached severe intensity over several days. Abnormalities of vibration QST thresholds preceded clinical symptoms. Treatment with 0.01 mg/kg every 4 hours produced a similar neuropathy, although of milder severity, later onset (mean, 9.3 weeks), and slower progression. In these patients, the onset of clinical symptoms and QST abnormalities were coincident. Only two of six patients treated with 0.005 mg/kg every 4 hours developed clinical or laboratory evidence of neuropathy; in both cases it was very mild and delayed in onset (26 weeks). All patients treated with high-dose ddC reported progression of symptoms (coasting) for 2 to 3 weeks following discontinuation of therapy. This study documents a painful sensory neuropathy resulting from treatment with ddC. With high-dose treatment, only the rapidity of onset and progression differentiated it from the distal, predominantly sensory neuropathy of AIDS.

Original languageEnglish (US)
Pages (from-to)358-362
Number of pages5
JournalNeurology
Volume43
Issue number2
StatePublished - Feb 1993

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Zalcitabine
Poisons
Acquired Immunodeficiency Syndrome
Sensory Thresholds
AIDS-Related Complex
Neural Conduction
Neurologic Examination
Peripheral Nervous System Diseases
Therapeutics
Clinical Protocols
Vibration
Antiviral Agents
HIV

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Berger, A. R., Arezzo, J. C., Schaumburg, H. H., Skowron, G., Merigan, T., Bozzette, S., ... Soo, W. (1993). 2′,3′-Dideoxycytidine (ddC) toxic neuropathy: A study of 52 patients. Neurology, 43(2), 358-362.

2′,3′-Dideoxycytidine (ddC) toxic neuropathy : A study of 52 patients. / Berger, A. R.; Arezzo, Joseph C.; Schaumburg, H. H.; Skowron, G.; Merigan, T.; Bozzette, S.; Richman, D.; Soo, W.

In: Neurology, Vol. 43, No. 2, 02.1993, p. 358-362.

Research output: Contribution to journalArticle

Berger, AR, Arezzo, JC, Schaumburg, HH, Skowron, G, Merigan, T, Bozzette, S, Richman, D & Soo, W 1993, '2′,3′-Dideoxycytidine (ddC) toxic neuropathy: A study of 52 patients', Neurology, vol. 43, no. 2, pp. 358-362.
Berger AR, Arezzo JC, Schaumburg HH, Skowron G, Merigan T, Bozzette S et al. 2′,3′-Dideoxycytidine (ddC) toxic neuropathy: A study of 52 patients. Neurology. 1993 Feb;43(2):358-362.
Berger, A. R. ; Arezzo, Joseph C. ; Schaumburg, H. H. ; Skowron, G. ; Merigan, T. ; Bozzette, S. ; Richman, D. ; Soo, W. / 2′,3′-Dideoxycytidine (ddC) toxic neuropathy : A study of 52 patients. In: Neurology. 1993 ; Vol. 43, No. 2. pp. 358-362.
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