WESTPORT, CT (Reuters Health) Oct 18 - Nerve growth factor (NGF)
significantly improves the pain symptoms of HIV-infected patients with
sensory neuropathy, according to a report in the October 9th issue of
The sensory neuropathy that affects as many as 35% of AIDS patients
predominantly affects small-fiber sensory nerves, the activity of which is
modulated to some degree by NGF, the authors explain.
Dr. Giovanni Schifitto, from the University of Rochester, New York, and
colleagues studied the safety and effectiveness of recombinant human NGF for
HIV-associated distal sensory polyneuropathy in 200 affected subjects.
Pain scores improved consistently in all patient groups (that is, patients
receiving either 0.1 µg NGF per kg or 0.3 µg NGF per kg), with the
higher-dose groups experiencing less pain and greater improvements than the
lower-dose groups, the authors report.
Though there were trends towards improvement in cooling and vibratory
sensation, the report indicates that only the higher-dose patients showed
significantly improved pin sensitivity.
Thirty-four moderate or severe adverse events included 28 complaints of
injection site discomfort, two cases of diarrhea, and one report each of
rash/urticaria, fatigue, impaired balance, and cough.
"Both the double-blind study and this open-label followup show symptomatic
improvement in patients treated with NGF," Dr. Schifitto told Reuters Health.
"A phase III study in HIV sensory neuropathy would be needed to clearly
define the efficacy of NGF in this population."
Dr. Schifitto said that as far as he knows, South San Francisco,
California-based biotechnology company Genentech Inc. "shelved NGF after the
negative results of the diabetic neuropathy study."
"The response to NGF in diabetic sensory neuropathy and HIV-associated
sensory neuropathy are not necessarily comparable, because the pathological
mechanisms involved may differ," he said. "Therefore, the negative results of
the phase III diabetic neuropathy study should not be extrapolated to HIV
Neurology Oct 6 2001;57:1313-1316.