Document Detail


Cidofovir for the treatment of recurrent respiratory papillomatosis: a review of the literature.
MedLine Citation:
PMID:  16006276     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recurrent respiratory papillomatosis (RRP) is a rare but potentially severe disease caused by papillomavirus, most often types 6 and 11. The disease, which occurs in both juvenile and adult forms, is characterized by benign epithelial tumors of the airway that most frequently affect the larynx but can also spread along the entire aerodigestive tract. Recurrent respiratory papillomatosis is the most common benign neoplasm of the larynx in children and the second most frequent cause of childhood hoarseness. Standard treatment, which is palliative only, consists of surgical excision of papillomata to maintain airway patency and improve voice quality. Recurrence despite repeated surgical procedures is the rule. To date, incorporation of adjuvant treatments has not been reliably beneficial in altering the disease course. Several case series have described promising results with cidofovir, a cytosine nucleoside analog with antiviral activity. To evaluate the data available on the safety and efficacy of cidofovir for the treatment of RRP, we conducted a MEDLINE search for all case reports or series from January 1966-August 2004 describing cidofovir therapy in either adults or children with RRP. The bibliographies of qualifying articles were also searched for relevant references. In both adults and children with mild-to-severe RRP, intralesional administration of cidofovir directly into the site of papillomata was associated with partial-to-complete regression of papillomata, improvement in voice quality and airway status, and decreased need for surgery. Wide variation in intralesional cidofovir dose (2-57 mg), frequency (every 2-8 wks), and duration (4 mo-4 yrs) was found. Successful outcomes have also been reported with intravenous cidofovir, but data are limited to three case reports. Rash, headache, and precordialgia were the only adverse effects reported with intralesional cidofovir. Nephrotoxicity and neutropenia secondary to either intralesional or intravenous cidofovir were not observed. Long-term risks associated with intralesional administration remain to be seen. Further studies are necessary to determine the most appropriate dose, frequency, and duration of therapy, and to fully characterize the safety profile profile of cidofovir when given intralesionally.
Authors:
Nadine Shehab; Burgunda V Sweet; Norman D Hogikyan
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pharmacotherapy     Volume:  25     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-11     Completed Date:  2005-10-26     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  977-89     Citation Subset:  IM    
Affiliation:
Department of Pharmacy Services, University of Michigan Health System, University Hospital, Ann Arbor, Michigan 48109-0008, USA. nshehab@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Antineoplastic Agents / administration & dosage,  adverse effects,  therapeutic use*
Child
Clinical Trials as Topic
Cytosine / administration & dosage,  adverse effects,  analogs & derivatives*,  therapeutic use
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Humans
Injections, Intralesional
Laryngeal Neoplasms / drug therapy,  surgery
Male
Neoplasm Recurrence, Local / drug therapy*,  surgery
Organophosphonates / administration & dosage,  adverse effects,  therapeutic use*
Papilloma / drug therapy*,  surgery
Respiratory Tract Neoplasms / drug therapy*,  surgery
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Organophosphonates; 71-30-7/Cytosine; JIL713Q00N/cidofovir

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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