Abstract
Distal sensory polyneuropathy (DSP) is the most frequent neurological complication of HIV infection. Neuropathic symptoms vary from mild paresthesias to severe pain that respond only partially to symptomatic treatment. Forty-five subjects with human immunodeficiency virus (HIV)-associated symptomatic DSP (SDSP) were enrolled in a randomized, multicenter, 16-week placebo-controlled study of memantine, an N-methyl-D-aspartate (NMDA) uncompetitive antagonist. Although memantine was well tolerated, no trend toward clinical benefit was observed. Results were similar to those of other pilot studies of memantine for neuropathic pain unrelated to HIV, suggesting that memantine is ineffective for the symptomatic treatment of HIV-associated SDSP.
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Acknowledgements
The authors acknowledge the following:
ACTG Operations Office: Sharon Shriver, MS, RPh; Stacy A. Bradley, BA
Harvard School of Public Health: Marc Vallée, Natasa Rajicic
CCG Representative: Michael Donnelly, James Weihe
Frontier Science & Technology Research Foundation: Linda Millar, BS; Dodi Colquhoun, MSc
Emory University Hospital: Angela Caliendo, MD, PhD
San Francisco General Hospital: Richard Price, MD
Stanford University Medical Center: Terrence F. Blaschke, MD
NIAID, DAIDS: Ana I. Martinez, RPh; Marjorie Dehlinger, DNSc.
NIH, NIMH, DSIR: Benedetto Vitiello, MD
Neurobiological Technology, Inc.: Lisa Carr
Participating sites
Beth Israel Medical Center (NY): Daniel MacGowan, MD; Donna Mildvan, MD
Harbor-UCLA: Gildon Beall, MD; Mario Guerrero, MD; Jorge Jovicich; Oliver Speck, PhD; Mallory Witt, MD
Harvard/Massachusetts General Hospital ACTU: Igor Koralinik, MD; Carol Delaney, RN (Beth Israel Deaconess Medical Center); Sandford Auerback, MD (Boston Medical Center); Nagagopal Venna, MD; Gilbert Roy, Jr., BA; Teri Flynn, ANP (Massachusetts General Hospital)
Mount Sinai Medical Center: Garnett Simpson, RN, MS; Pieter Gerits, RN
Northwestern University Medical Center: Bruce Cohen, MD; Catherine Cooper, RN
Rush Medical College, Cook County Hospital: David Barker, MD; Russell Bartt, MD
State University of New York at Buffalo: Ross G. Hewiit, MD; Holly Ingelfinger-Lopez, RN
University of California at Los Angeles: Suzette A. Chafey, RN, NP, BSN, MPH
University of California at San Diego: Ron Snyder, RN; Jill Kunkel, RN; Julie Rippeth, PhD
University of Hawaii: Debbie Ogata-Arakaki, MD; Nancy Hanks, RN; Scott Souza, PharmD, John A. Burns School of Medicine Queen's Medical Center
University of Kentucky: Richard Greenberg, MD
University of Miami: Karl Goodkin, MD; Margaret Fischl, MD
University of Nebraska Medical Center: Susan Swindells, MBBS; Howard E. Gendleman, MD
University of Pennsylvania Medical Center: Robert Lenkinski, PhD
University of Rochester: Richard Reichman, MD; Mary Shoemaker, RN
University of Texas Medical Center, Galveston: Robert R. McKendall, MD; Richard B. Pollard, MD; Michael Borucki, MD; Karen Waterman, RN; Gloria Carrera, PA
University of Washington: Margot Schwartz, MD; N. Jeanne Conley, RN; Ann C. Collier, MD
Washington University: David B. Clifford, MD; Lisa Kessels, RN, ACRN; Mary Gould, RN, BA
The current address of Constantin T. Yiannoutsos is Indiana University School of Medicine, Indianapolis, Indiana, USA.
Giovanni Schifitto had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
The study received support from the AIDS Clinical Trials Group, R01NS34626, R01RR13213, R01NS38834, AI-38855 and RR00044. G. Schifitto receives support from R01MH64409 and MH64570. The authors would like also to acknowledge Diane Rausch for additional NIMH support, Hans J. Moebius, MD, PhD, Merz Pharmaceuticals, and Shirley Chen, PharmD, CNS Medical Affairs, Forrest Laboratories.