Staff View: Age and height predict neuropathy risk in patients with HIV prescribed stavudine

Age and height predict neuropathy risk in patients with HIV prescribed stavudine

Objective: Sensory neuropathy is a common problem in HIV-infected patients and is the dose-limiting toxicity of stavudine. Affordable methods of predicting neuropathy risk are needed to guide prescribing in countries where some use of stavudine remains an economic necessity. We therefore aimed to id...

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Main Authors:	Cherry, C.L., Affandi, J.S., Imran, D., Yunihastuti, E., Smyth, K., Vanar, S., Kamarulzaman, A., Price, P.
Format:	Article
Published:	2009
Subjects:	R Medicine
Online Access:	http://eprints.um.edu.my/4540/ http://www.ncbi.nlm.nih.gov/pubmed/19636052
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spelling	my.um.eprints.45402014-12-19T03:17:26Z http://eprints.um.edu.my/4540/ Age and height predict neuropathy risk in patients with HIV prescribed stavudine Cherry, C.L. Affandi, J.S. Imran, D. Yunihastuti, E. Smyth, K. Vanar, S. Kamarulzaman, A. Price, P. R Medicine Objective: Sensory neuropathy is a common problem in HIV-infected patients and is the dose-limiting toxicity of stavudine. Affordable methods of predicting neuropathy risk are needed to guide prescribing in countries where some use of stavudine remains an economic necessity. We therefore aimed to identify factors predictive of neuropathy risk before antiretroviral use. Methods: A total of 294 patients attending clinics in Melbourne, Kuala Lumpur, and Jakarta were enrolled in a cross-sectional neuropathy screening program in 2006. Neuropathy was defined by the presence of symptoms and signs on the AIDS Clinical Trials Group Brief Peripheral Neuropathy Screen. Demographic, laboratory, and treatment details were considered as possible risk factors for neuropathy. The role of patient demographics in predicting stavudine neuropathy were then assessed in 181 patients who reported that they were free of neuropathy symptoms when first prescribed this drug. Results: The prevalence of neuropathy was 42 in Melbourne (n = 100), 19 in Kuala Lumpur (n = 98), and 34 in Jakarta (n = 96). In addition to treatment exposures, increasing age (p = 0.002) and height (p = 0.001) were independently associated with neuropathy. Age and height cutoffs of >= 170 cm or >= 40 years predicted neuropathy. Among 181 patients who were asymptomatic before stavudine exposure, the risk of neuropathy following stavudine was 20 in younger, shorter patients, compared with 66 in older, taller individuals. Conclusions: Stavudine neuropathy risk increases with patient age and height. Prioritizing older and taller patients for alternative agents would be an inexpensive strategy to reduce neuropathy rates in countries where the burden of HIV disease limits treatment options. Neurology (R) 2009; 73: 315-320 2009 Article PeerReviewed Cherry, C.L. and Affandi, J.S. and Imran, D. and Yunihastuti, E. and Smyth, K. and Vanar, S. and Kamarulzaman, A. and Price, P. (2009) Age and height predict neuropathy risk in patients with HIV prescribed stavudine. Neurology, 73 (4). pp. 315-320. ISSN 0028-3878 http://www.ncbi.nlm.nih.gov/pubmed/19636052
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	R Medicine
spellingShingle	R Medicine Cherry, C.L. Affandi, J.S. Imran, D. Yunihastuti, E. Smyth, K. Vanar, S. Kamarulzaman, A. Price, P. Age and height predict neuropathy risk in patients with HIV prescribed stavudine
description	Objective: Sensory neuropathy is a common problem in HIV-infected patients and is the dose-limiting toxicity of stavudine. Affordable methods of predicting neuropathy risk are needed to guide prescribing in countries where some use of stavudine remains an economic necessity. We therefore aimed to identify factors predictive of neuropathy risk before antiretroviral use. Methods: A total of 294 patients attending clinics in Melbourne, Kuala Lumpur, and Jakarta were enrolled in a cross-sectional neuropathy screening program in 2006. Neuropathy was defined by the presence of symptoms and signs on the AIDS Clinical Trials Group Brief Peripheral Neuropathy Screen. Demographic, laboratory, and treatment details were considered as possible risk factors for neuropathy. The role of patient demographics in predicting stavudine neuropathy were then assessed in 181 patients who reported that they were free of neuropathy symptoms when first prescribed this drug. Results: The prevalence of neuropathy was 42 in Melbourne (n = 100), 19 in Kuala Lumpur (n = 98), and 34 in Jakarta (n = 96). In addition to treatment exposures, increasing age (p = 0.002) and height (p = 0.001) were independently associated with neuropathy. Age and height cutoffs of >= 170 cm or >= 40 years predicted neuropathy. Among 181 patients who were asymptomatic before stavudine exposure, the risk of neuropathy following stavudine was 20 in younger, shorter patients, compared with 66 in older, taller individuals. Conclusions: Stavudine neuropathy risk increases with patient age and height. Prioritizing older and taller patients for alternative agents would be an inexpensive strategy to reduce neuropathy rates in countries where the burden of HIV disease limits treatment options. Neurology (R) 2009; 73: 315-320
format	Article
author	Cherry, C.L. Affandi, J.S. Imran, D. Yunihastuti, E. Smyth, K. Vanar, S. Kamarulzaman, A. Price, P.
author_facet	Cherry, C.L. Affandi, J.S. Imran, D. Yunihastuti, E. Smyth, K. Vanar, S. Kamarulzaman, A. Price, P.
author_sort	Cherry, C.L.
title	Age and height predict neuropathy risk in patients with HIV prescribed stavudine
title_short	Age and height predict neuropathy risk in patients with HIV prescribed stavudine
title_full	Age and height predict neuropathy risk in patients with HIV prescribed stavudine
title_fullStr	Age and height predict neuropathy risk in patients with HIV prescribed stavudine
title_full_unstemmed	Age and height predict neuropathy risk in patients with HIV prescribed stavudine
title_sort	age and height predict neuropathy risk in patients with hiv prescribed stavudine
publishDate	2009
url	http://eprints.um.edu.my/4540/ http://www.ncbi.nlm.nih.gov/pubmed/19636052
_version_	1643687357124182016
score	13.211869

Age and height predict neuropathy risk in patients with HIV prescribed stavudine

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