Research has shown that stavudine can degrade to thymine under hydrolytic, oxidative and photolytic conditions.
Kamsaladevi K. Naidoo, Thavendran Govender, Rellissa A. Deonunan, Terusha Govender,Calveni Naidoo, Ramona Moodley, Melissa Govender, Khahliso P. Miya 2009, 'Post-dispensing stability surveillance: Stavudine', African Journal of Primary Health Care & Family Medicinehttps://phcfm.org/index.php/phcfm/article/view/14. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
The median duration on stavudine treatment was 14.5 months.
Levitt Naomi S, Dave Joel A, Smith Peter J, Badri Motasim, McIlleron Helen M, vander Walt Jan-Stefan, Sinxadi Phumla Z, Maartens Gary 2010, 'Lack of association between stavudine exposure and lipoatrophy, dysglycaemia, hyperlactataemiaand hypertriglyceridaemia: a prospective cross sectional study', AIDS Research and Therapyhttp://www.aidsrestherapy.com/content/7/1/23. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Didanosine resistance was observed in 43.2% of patients exposed to stavudine-based regimens.
Kim Steegen, Leon Levin, Irene Ketseoglou, Michelle Bronze, Maria A Papathanasopoulos,Sergio Carmona, Wendy Stevens 2014, 'High-level cross-resistance to didanosine observed in South African children failingan abacavir- or stavudine-based 1st-line regimen.', PLoS ONEhttp://europepmc.org/articles/PMC4016228?pdf=render. Retrieved from PLOS CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Doctors were equally concerned about stavudine-induced lactic acidosis and lipoatrophy.
Willem Daniel Francois Venter, Lee Fairlie, Charles Feldman, Peter Cleaton-Jones,Matthew Chersich 2016, 'Views of Medical Doctors Regarding the 2013 WHO Adult HIV Treatment Guidelines IndicateVariable Applicability for Routine Patient Monitoring, for Their Family Members andfor Themselves, in South-Africa.', PLoS ONEhttp://europepmc.org/articles/PMC4721595?pdf=render. Retrieved from PLOS CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Stavudine-containing regimens should be avoided in obese female patients.
M Nlooto, E Osuch, W du Plooy 2013, 'Stavudine dosage reduction: Effect on symptomatic hyperlactataemia and lactic acidosisin patients at Dr George Mukhari Hospital, Pretoria', Southern African Journal of HIV Medicinehttps://sajhivmed.org.za/index.php/hivmed/article/view/101. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Phasing-out of stavudine should be implemented, as costs allows.
Vichet Phan, Sopheak Thai, Kimcheng Choun, Lutgarde Lynen, Johan van Griensven 2012, 'Incidence of treatment-limiting toxicity with stavudine-based antiretroviral therapyin Cambodia: a retrospective cohort study.', PLoS ONEhttp://europepmc.org/articles/PMC3267733?pdf=render. Retrieved from PLOS CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
5.5% stopped stavudine, 1.3% died and 4.0% defaulted during follow up.
Joep J van Oosterhout, Jane Mallewa, Symon Kaunda, Newton Chagoma, Yassin Njalale,Elizabeth Kampira, Mavuto Mukaka, Robert S Heyderman 2012, 'Stavudine toxicity in adult longer-term ART patients in Blantyre, Malawi.', PLoS ONEhttp://europepmc.org/articles/PMC3406059?pdf=render. Retrieved from PLOS CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
The pharmacokinetic parameters of stavudine in different formulations were calculated by noncompartment model statistics.
Fengdan Jin 2014, 'Liquid Chromatography-Tandem Mass Spectrometric Assay for Determination of Stavudinein Human Plasma', Journal of Spectroscopyhttp://dx.doi.org/10.1155/2014/517089. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Current recommendations advise that stavudine be phased out of use.
Steve Innes, Mark Cotton, Francois Venter 2011, 'Why should we still care about the stavudine dose?', Southern African Journal of HIV Medicinehttps://sajhivmed.org.za/index.php/hivmed/article/view/166. Retrieved from DOAJ CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)
Four-year rates of all-cause and stavudine-specific toxicity were estimated.
Mar Pujades-Rodríguez, Emmanuelle Dantony, Loretxu Pinoges, René Ecochard, Jean-FrançoisEtard, Esther Carrillo-Casas, Elisabeth Szumilin 2011, 'Toxicity associated with stavudine dose reduction from 40 to 30 mg in first-line antiretroviraltherapy.', PLoS ONEhttp://europepmc.org/articles/PMC3221698?pdf=render. Retrieved from PLOS CC BY 4.0 (https://creativecommons.org/licenses/by-sa/4.0/legalcode)