Safety of GM-CSF in Patients with AIDS: A Review of the Literature

• Published in: Pharmacotherapy 1998-11, Vol.18 (6), p.1290-1297
• Main Authors: Ross, Susan D., DiGeorge, Angela, Connelly, Janet E., Whiting, Gregory W., McDonnell, Neil
• Format: Article
• Language: English
• Subjects: Acquired Immunodeficiency Syndrome - drug therapy; Acquired Immunodeficiency Syndrome - virology; AIDS/HIV; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Clinical Trials as Topic; Granulocyte-Macrophage Colony-Stimulating Factor - therapeutic use; HIV - drug effects; Humans; Medical sciences; Pharmacology. Drug treatments; Treatment Outcome
• ISSN: 0277-0008; 1875-9114
• DOI: 10.1002/j.1875-9114.1998.tb03150.x

We performed a literature search for all clinical studies reporting outcomes in patients with the acquired immunodeficiency syndrome (AIDS) receiving granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) for any indication. Safety outcomes included human immunodeficiency virus replication, immune status, and frequency of opportunistic infections and neoplasms. Data were synthesized qualitatively. We identified 22 studies (274 patients): 12 addressed AIDS neutropenia, 8 AIDS cancer therapy, and 2 opportunistic infections. Viral burden was assessed by serum p24Ag in 15 studies. Nine reported no change in levels, three net decreases, and three net increases. All studies showing net increases involved patients receiving GM‐CSF without a concurrent antiretroviral. The CD4 counts were unchanged in 5 studies, increased in 3, and not reported in 14. The incidence of neoplasms or new opportunistic infections was low. The literature suggests no increased risk of viral replication or clinical deterioration in patients with AIDS who take GM‐CSF concurrently with zidovudine.