- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT00000979
Comparison of ddI Versus Zidovudine in HIV-Infected Patients
Comparison of 2',3'-Dideoxyinosine (ddI) (BMY-40900) and Zidovudine in Therapy of Patients With HIV Infection
To compare the effectiveness and toxicity of didanosine (ddI) and zidovudine (AZT) in patients with AIDS, advanced AIDS-related complex (ARC), or asymptomatic infection with CD4 counts < 200 cells/mm3.
AZT is effective in reducing mortality in patients with AIDS who receive the drug after the first episode of Pneumocystis carinii pneumonia (PCP) and in patients with advanced ARC. However, AZT therapy has been associated with significant toxicities. In addition, the effectiveness of AZT appears to decrease during the second and third years of therapy. For these reasons, the development of alternative therapy that would be at least as effective but less toxic is of great importance. The drug ddI is an antiviral agent that inhibits replication (reproduction) of HIV with less apparent toxicity than AZT.
Přehled studie
Detailní popis
AZT is effective in reducing mortality in patients with AIDS who receive the drug after the first episode of Pneumocystis carinii pneumonia (PCP) and in patients with advanced ARC. However, AZT therapy has been associated with significant toxicities. In addition, the effectiveness of AZT appears to decrease during the second and third years of therapy. For these reasons, the development of alternative therapy that would be at least as effective but less toxic is of great importance. The drug ddI is an antiviral agent that inhibits replication (reproduction) of HIV with less apparent toxicity than AZT.
AMENDED: 9/28/90 Patients are assigned to one of 2 treatments under a double-blind, randomly allocated, experimental design if their duration of prior AZT therapy is 0 to 16 weeks. (Patients who entered with no more than 16 weeks prior AZT and who were randomized to ddI will continue to be dosed at that level, adjusted for weight, and followed as originally planned.) Patients are assigned to one of 3 treatments as explained prior to this amendment if their duration of prior to AZT therapy is greater than 16 weeks. Original design: Patients are assigned to one of three treatments under a double-blind randomly allocated experimental design. ddI will be administered at two dose levels.
It is anticipated that patients will be seen as outpatients every 2 weeks for the first 4 weeks of the study and monthly thereafter. This study continues for at least 18 months after the entry of the first subject.
Typ studie
Zápis
Fáze
- Fáze 2
Kontakty a umístění
Studijní místa
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San Juan, Portoriko, 009275800
- San Juan Veterans Administration Med Ctr
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California
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Los Angeles, California, Spojené státy, 900276016
- Children's Hosp of Los Angeles/UCLA Med Ctr
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Los Angeles, California, Spojené státy, 90033
- Los Angeles County - USC Med Ctr
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Palo Alto, California, Spojené státy, 94304
- Palo Alto Veterans Adm Med Ctr / Stanford Univ
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San Diego, California, Spojené státy, 921036325
- Univ of California / San Diego Treatment Ctr
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Stanford, California, Spojené státy, 94305
- Stanford Univ School of Medicine
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Sylmar, California, Spojené státy, 91342
- Olive View Med Ctr
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Sylmar, California, Spojené státy, 91342
- Sepulveda Veterans Adm Med Ctr / Olive View Med Ctr
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Torrance, California, Spojené státy, 90502
- Harbor UCLA Med Ctr
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Colorado
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Denver, Colorado, Spojené státy, 80262
- Univ of Colorado Health Sciences Ctr
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Denver, Colorado, Spojené státy, 80262
- Mountain States Regional Hemophilia Ctr / Univ of Colorado
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District of Columbia
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Washington, District of Columbia, Spojené státy, 20037
- George Washington Univ Med Ctr
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Washington, District of Columbia, Spojené státy, 20009
- Whitman - Walker Clinic
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Florida
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Fort Lauderdale, Florida, Spojené státy, 33316
- G E Morey Jr
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Miami, Florida, Spojené státy, 331361013
- Univ of Miami School of Medicine
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Illinois
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Chicago, Illinois, Spojené státy, 60611
- Northwestern Univ Med School
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Chicago, Illinois, Spojené státy, 60612
- Rush Presbyterian - Saint Luke's Med Ctr
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Chicago, Illinois, Spojené státy, 60612
- Cook County Hosp
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Hines, Illinois, Spojené státy, 60141
- Edward Hines Veterans Administration Hosp
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Indiana
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Indianapolis, Indiana, Spojené státy, 462025250
- Indiana Univ Hosp
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Kansas
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Wichita, Kansas, Spojené státy, 67214
- Univ of Kansas School of Medicine
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Louisiana
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New Orleans, Louisiana, Spojené státy, 70112
- Louisiana Comprehensive Hemophilia Care Ctr
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New Orleans, Louisiana, Spojené státy, 70112
- Louisiana State Univ Med Ctr / Tulane Med School
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New Orleans, Louisiana, Spojené státy, 70112
- Tulane Univ School of Medicine
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New Orleans, Louisiana, Spojené státy, 70112
- Charity Hosp / Tulane Univ Med School
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Maryland
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Baltimore, Maryland, Spojené státy, 21287
- Johns Hopkins Hosp
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Massachusetts
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Boston, Massachusetts, Spojené státy, 02114
- Harvard (Massachusetts Gen Hosp)
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Boston, Massachusetts, Spojené státy, 02118
- Boston Med Ctr
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Boston, Massachusetts, Spojené státy, 02215
- Beth Israel Deaconess - West Campus
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Boston, Massachusetts, Spojené státy, 02215
- Beth Israel Deaconess Med Ctr
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Springfield, Massachusetts, Spojené státy, 01199
- Baystate Med Ctr of Springfield
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Worcester, Massachusetts, Spojené státy, 01605
- Med Ctr of Central Massachusetts
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Worcester, Massachusetts, Spojené státy, 01655
- Univ of Massachusetts Med Ctr
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Minnesota
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Minneapolis, Minnesota, Spojené státy, 55455
- Univ of Minnesota
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Nebraska
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Omaha, Nebraska, Spojené státy, 68105
- Nebraska Regional Hemophilia Ctr
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New York
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Bronx, New York, Spojené státy, 10461
- Bronx Municipal Hosp Ctr/Jacobi Med Ctr
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Bronx, New York, Spojené státy, 10465
- Jack Weiler Hosp / Bronx Municipal Hosp
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Bronx, New York, Spojené státy, 10467
- Montefiore Med Ctr / Bronx Municipal Hosp
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Bronx, New York, Spojené státy, 10468
- Bronx Veterans Administration / Mount Sinai Hosp
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Buffalo, New York, Spojené státy, 14215
- SUNY / Erie County Med Ctr at Buffalo
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Elmhurst, New York, Spojené státy, 11373
- City Hosp Ctr at Elmhurst / Mount Sinai Hosp
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New York, New York, Spojené státy, 10021
- Cornell Univ Med Ctr
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New York, New York, Spojené státy, 10003
- Beth Israel Med Ctr / Peter Krueger Clinic
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New York, New York, Spojené státy, 10016
- Bellevue Hosp / New York Univ Med Ctr
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New York, New York, Spojené státy, 10021
- Mem Sloan - Kettering Cancer Ctr
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New York, New York, Spojené státy, 10025
- Saint Luke's - Roosevelt Hosp Ctr
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New York, New York, Spojené státy, 10029
- Mount Sinai Med Ctr
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Rochester, New York, Spojené státy, 14642
- Univ of Rochester Medical Center
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Stony Brook, New York, Spojené státy, 117948153
- SUNY - Stony Brook
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Syracuse, New York, Spojené státy, 13210
- SUNY / State Univ of New York
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North Carolina
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Chapel Hill, North Carolina, Spojené státy, 275997215
- Univ of North Carolina
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Durham, North Carolina, Spojené státy, 27710
- Duke Univ Med Ctr
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Winston-Salem, North Carolina, Spojené státy, 27103
- Bowman Gray School of Medicine / Wake Forest Univ
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Ohio
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Cincinnati, Ohio, Spojené státy, 452670405
- Holmes Hosp / Univ of Cincinnati Med Ctr
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Columbus, Ohio, Spojené státy, 432101228
- Ohio State Univ Hosp Clinic
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Toledo, Ohio, Spojené státy, 43699
- Med College of Ohio
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Pennsylvania
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Hershey, Pennsylvania, Spojené státy, 170330850
- Milton S Hershey Med Ctr
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Philadelphia, Pennsylvania, Spojené státy, 19104
- Univ of Pennsylvania
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Pittsburgh, Pennsylvania, Spojené státy, 15219
- Hemophilia Ctr of Western PA / Univ of Pittsburgh
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Pittsburgh, Pennsylvania, Spojené státy
- Univ of Pittsburgh Med School
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South Carolina
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West Columbia, South Carolina, Spojené státy, 29169
- Julio Arroyo
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Tennessee
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Knoxville, Tennessee, Spojené státy, 37920
- Univ of Tennessee / E Tennessee Comprehensive Hemophilia Ctr
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Texas
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Galveston, Texas, Spojené státy, 77550
- Univ TX Galveston Med Branch
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Houston, Texas, Spojené státy, 77030
- Hermann Hosp / Univ Texas Health Science Ctr
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Houston, Texas, Spojené státy, 77030
- Texas Children's Hosp / Baylor Univ
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Utah
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Salt Lake City, Utah, Spojené státy, 84132
- Univ of Utah School of Medicine
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Virginia
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Hampton, Virginia, Spojené státy, 23666
- Dr Stephen L Green
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Washington
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Seattle, Washington, Spojené státy, 98105
- Univ of Washington
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Wisconsin
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Milwaukee, Wisconsin, Spojené státy, 53215
- Dr Brian Buggy
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Milwaukee, Wisconsin, Spojené státy, 53226
- Milwaukee County Med Complex
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Milwaukee, Wisconsin, Spojené státy, 53233
- Great Lakes Hemophilia Foundation
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria
Concurrent Medication:
Required:
- Aerosolized pentamidine (300 mg every 4 weeks using a Respirgard II nebulizer). In the event of physiological intolerance, alternative prophylaxis may be: Trimethoprim / sulfamethoxazole 1 DS tab per day or dapsone 50 - 100 mg/day.
Allowed:
Maintenance therapy for active AIDS defining opportunistic infections for patients with 9 to 47 weeks' experience with zidovudine (AZT).
Treatment of opportunistic infections with other than sulfonamide containing drugs:
- Pyrimethamine and sulfadiazine or clindamycin for suppression of toxoplasmosis acquired after study entry; fluconazole or amphotericin B for suppression of cryptococcosis or ketoconazole for candidiasis.
Intravenous acyclovir for up to 10 days. Erythropoietin for patients under the relevant treatment IND. Analgesics, antihistamines, antiemetics, antidiarrheal agents for symptomatic therapy for toxicities.
Isoniazid (INH) if no other acceptable therapy is available.
Metronidazole may be used for single courses of therapy not to exceed 14 days within consecutive 90 day intervals. Note:
- Ketoconazole and dapsone should be taken 2 hours before or 2 hours after taking ddI (amendment 5/20/91).
Concurrent Treatment:
Allowed:
- Blood transfusions for hemoglobin toxicity.
Patients must:
- Have a diagnosis of AIDS or advanced AIDS related complex (ARC), or per 8/09/90 amendment, asymptomatic HIV infection with CD4 count = or < 200 cells/mm3.
- Be either naive to zidovudine (AZT) or have taken AZT for = or < 48 weeks.
- Have ended treatment for acute Pneumocystis carinii pneumonia (PCP) at least 2 weeks before study entry. For patients with 2 months or less experience with AZT, PCP infection will be the single and only AIDS-defining infection and must have been within 120 days of study entry. Per amendment, other AIDS-defining conditions are allowed in the 8 weeks prior to study entry (for patients in the AZT stratum).Only one episode of PCP is permitted unless patient has > 2 months AZT experience in which case > 1 prior episode of PCP infection is allowed.
- Not have experienced a major intolerance to AZT at doses of at least 500 mg if the patient was on AZT therapy for = or < 48 weeks. A major intolerance is defined as recurrent grade 3 or greater toxicity which results in discontinuation of drug.
Allowed:
- Basal cell carcinoma.
- In situ carcinoma of the cervix.
- Occasional premature atrial or ventricular contraction.
- Patients developing new opportunistic infections after study entry will remain on this protocol.
- Patients whose AIDS-defining condition is Kaposi's sarcoma alone must have CD4 cell counts < 300 cells/mm3.
Prior Medication:
Allowed:
- Previous treatment with zidovudine (AZT) up to 48 weeks.
Exclusion Criteria
Co-existing Condition:
Patients with the following symptoms or diseases are excluded:
- Kaposi's sarcoma (KS) with evidence of visceral disease or where KS requires chemotherapy; subjects with localized KS having CD4 counts = or > 200 cells/mm3.
- AIDS-dementia complex = or > stage 2.
- Prior history of acute pancreatitis within past 2 years or chronic pancreatitis.
- Intractable diarrhea.
- History of seizures within past 6 months or currently requiring anticonvulsants for control.
- History of past or current heart disease.
- Presence of a malignancy likely in the investigators opinion to require cytotoxic myelosuppressive chemotherapy during the expected course of this trial.
Concurrent Medication:
Excluded:
- Oral acidifying agents.
- Neurotoxic drugs. NOTE: If patients require therapy for PCP with IV pentamidine, study mediation is stopped.
Patients with the following are excluded:
- Active AIDS defining events. Maintenance therapy for prior AIDS-defining opportunistic infections is permitted.
- Intolerance to AZT at doses of 500 mg because of recurrent grade 3 toxicity or greater which resulted in discontinuation of drug.
- Neoplasms not specifically allowed.
- Previous enrollment in any study of ddI, ddC or d4T.
- > 48 weeks of AZT therapy.
- An opportunistic infection not adequately controlled with suppressive therapies allowed in the protocol.
- Psychological or emotional problems sufficient, in the investigator's opinion, to prevent adequate compliance study therapy.
- Life expectancy = or < 6 months.
Prior Medication:
Excluded:
- Ganciclovir.
- AZT for = or > 48 weeks.
Excluded within 14 days of study entry:
- Erythropoietin (Eprex).
Excluded within 30 days of study entry:
- Anti-HIV therapy other than AZT.
- Biologic response modifiers.
- Other investigational drugs.
- Corticosteroids.
- Neurotoxic drugs.
Excluded within 90 days of study entry:
- Ribavirin.
Prior Treatment:
Excluded within 14 days of study entry:
- Transfusion.
Active alcohol or drug abuse sufficient, in the investigator's opinion, to prevent adequate compliance with study therapy.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
Spolupracovníci a vyšetřovatelé
Spolupracovníci
Vyšetřovatelé
- Studijní židle: R Dolin
Publikace a užitečné odkazy
Obecné publikace
- Bozzette SA, Hays RD, Berry SH, Kanouse DE. A Perceived Health Index for use in persons with advanced HIV disease: derivation, reliability, and validity. Med Care. 1994 Jul;32(7):716-31. doi: 10.1097/00005650-199407000-00005.
- Fiscus SA, Heggem-Snow A, Troiani L, Wallmark E, Folds JD, Sheff B, van der Horst CM. Transient high titers of HIV-1 in plasma and progression of disease. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 May 1;9(1):51-7.
- Kozal MJ, Kroodsma K, Winters MA, Shafer RW, Efron B, Katzenstein DA, Merigan TC. Didanosine resistance in HIV-infected patients switched from zidovudine to didanosine monotherapy. Ann Intern Med. 1994 Aug 15;121(4):263-8. doi: 10.7326/0003-4819-121-4-199408150-00005.
- Schooley RT. Correlation between viral load measurements and outcome in clinical trials of antiviral drugs. AIDS. 1995 Dec;9 Suppl 2:S15-S19.
- Dolin R, Amato DA, Fischl MA, Pettinelli C, Beltangady M, Liou SH, Brown MJ, Cross AP, Hirsch MS, Hardy WD, et al. Zidovudine compared with didanosine in patients with advanced HIV type 1 infection and little or no previous experience with zidovudine. AIDS Clinical Trials Group. Arch Intern Med. 1995 May 8;155(9):961-74. Erratum In: Arch Intern Med 1995 Nov 13;155(20):2255.
- Fichtenbaum CJ, Clifford DB, Powderly WG. Risk factors for dideoxynucleoside-induced toxic neuropathy in patients with the human immunodeficiency virus infection. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Oct 1;10(2):169-74. doi: 10.1097/00042560-199510020-00009.
- Spino C, Kahn JO, Dolin R, Phair JP. Predictors of survival in HIV-infected persons with 50 or fewer CD4 cells/mm3. J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Aug 15;15(5):346-55. doi: 10.1097/00042560-199708150-00004.
- Richardson D, Liou SH, Kahn JO. Uric acid and didanosine compliance in AIDS clinical trials: an analysis of AIDS Clinical Trials Group protocols 116A and 116B/117. J Acquir Immune Defic Syndr (1988). 1993 Nov;6(11):1212-23.
- Welles SL, Jackson JB, Yen-Lieberman B, Demeter L, Japour AJ, Smeaton LM, Johnson VA, Kuritzkes DR, D'Aquila RT, Reichelderfer PA, Richman DD, Reichman R, Fischl M, Dolin R, Coombs RW, Kahn JO, McLaren C, Todd J, Kwok S, Crumpacker CS. Prognostic value of plasma human immunodeficiency virus type 1 (HIV-1) RNA levels in patients with advanced HIV-1 disease and with little or no prior zidovudine therapy. AIDS Clinical Trials Group Protocol 116A/116B/117 Team. J Infect Dis. 1996 Oct;174(4):696-703. doi: 10.1093/infdis/174.4.696.
- Coombs RW, Welles SL, Hooper C, Reichelderfer PS, D'Aquila RT, Japour AJ, Johnson VA, Kuritzkes DR, Richman DD, Kwok S, Todd J, Jackson JB, DeGruttola V, Crumpacker CS, Kahn J. Association of plasma human immunodeficiency virus type 1 RNA level with risk of clinical progression in patients with advanced infection. AIDS Clinical Trials Group (ACTG) 116B/117 Study Team. ACTG Virology Committee Resistance and HIV-1 RNA Working Groups. J Infect Dis. 1996 Oct;174(4):704-12. doi: 10.1093/infdis/174.4.704.
- Mildvan D, Spritzler J, Grossberg SE, Fahey JL, Johnston DM, Schock BR, Kagan J. Serum neopterin, an immune activation marker, independently predicts disease progression in advanced HIV-1 infection. Clin Infect Dis. 2005 Mar 15;40(6):853-8. doi: 10.1086/427877. Epub 2005 Feb 18.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Primární dokončení (Aktuální)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Odhad)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
- RNA virové infekce
- Virová onemocnění
- Infekce přenášené krví
- Přenosné nemoci
- Pohlavně přenosné choroby, virové
- Pohlavně přenosné nemoci
- Lentivirové infekce
- Retroviridae infekce
- Syndromy imunologické nedostatečnosti
- Onemocnění imunitního systému
- Pomalá virová onemocnění
- HIV infekce
- Infekce
- Syndrom získané immunití nedostatečnisti
- Molekulární mechanismy farmakologického působení
- Antiinfekční látky
- Antivirová činidla
- Inhibitory reverzní transkriptázy
- Inhibitory syntézy nukleových kyselin
- Inhibitory enzymů
- Anti-HIV činidla
- Antiretrovirová činidla
- Antimetabolity
- Zidovudin
- Didanosin
Další identifikační čísla studie
- ACTG 116
- 070V1
- ACTG 116-A
- ACTG 116-B/117
- AI454-008
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
produkt vyrobený a vyvážený z USA
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .
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