- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT00432003
Effects of Anti-HIV Therapy on Nervous System Function
Neurology: A Substudy of a Large, Simple Trial Comparing Two Strategies for Management of Anti-Retroviral Therapy (SMART) to Determine the Impact of the Strategies Upon Central and Peripheral Nervous System Function
Přehled studie
Postavení
Podmínky
Detailní popis
AIDS dementia complex (ADC) is a condition characterized by cognitive impairment, psychomotor slowing, and behavioral change. A milder form of ADC, called HIV minor cognitive/motor disorder (MCMD), is characterized by similar symptoms but has less of an impact on daily functioning. The neurocognitive impairment that results from ADC and MCMD carries an increased risk of poor drug adherence, morbidity, and mortality. It is unclear if highly active antiretroviral therapy (HAART) is effective in preserving neurocognitive function or in preventing or treating neurocognitive impairment. Distal symmetric sensory polyneuropathy (DSPN) and nucleoside-related neuropathy are two other serious conditions that HIV patients are at high risk for. DSPN is thought to be caused by active HIV infection; nucleoside-related neuropathy is thought to be caused by mitochondrial toxicity related to the use of certain antiretrovirals. These 2 conditions may lead to severe pain and discomfort in the feet. It is unknown what connection, if any, there is between DSPN and nucleoside-related neuropathy and the use of HAART. More data are needed on the natural history of these conditions.
This trial is a substudy of a study of management of antiretroviral therapy (SMART). In the SMART study, patients will participate in one of two strategies: a drug conservation (DC) strategy and a viral suppression (VS) strategy. Participants in the DC group will stop or defer HAART, then receive episodic HAART treatment for the minimum time needed to maintain a CD4 cell count of at least 250 cells/mm3. Participants in the VS group will receive HAART to maintain a viral load as low as possible, regardless of CD4 count. The purpose of this study is to compare changes in neurocognitive functioning and peripheral neuropathy symptoms between the 2 strategies of the SMART study.
Patients will participate in this substudy and the main SMART study at the same time. Within 45 days prior to randomization into the main SMART study, participants will have baseline data collected for this substudy. This data will include peripheral neuropathy assessments, treatments for symptoms of peripheral neuropathy. At selected study sites, additional measures will assess neurocognitive function, depression, alcohol and drug use, and education. At 6 months, 12 months, and every 12 months thereafter, peripheral neuropathy symptoms and treatment for the symptoms will be assessed; a pain questionnaire will also be completed. Participants will be followed until the SMART study ends.
Typ studie
Zápis (Aktuální)
Kontakty a umístění
Studijní místa
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New South Wales
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Burwood, New South Wales, Austrálie, 2134
- Burwood Road Gen. Practice CRS
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Darlinghurst, New South Wales, Austrálie, 2010
- St. Vincent's Hospital CRS
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Westmead, New South Wales, Austrálie, 2145
- Westmead Hospital CRS
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Victoria
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Carlton,, Victoria, Austrálie
- Melbourne Sexual Health Ctr. CRS
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Melbourne, Victoria, Austrálie, 3004
- The Alfred Hosp., Clinical Research - Infectious Diseases Unit CRS
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Melbourne, Victoria, Austrálie, 3181
- Prahran Market Clinic CRS
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Sao Paulo, Brazílie, 01246-900
- Instituto de Infectologia Emilio Ribas CRS
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Bahia
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Salvador, Bahia, Brazílie, 40110-160
- Hosp. Universitario Prof. Edgard SantosCRS
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Nova Scotia
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Halifax, Nova Scotia, Kanada, B3H 2Y9
- Q.E. II Health Sciences Ctr., Captial District Authority, Victoria Gen. Hosp. CRS
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Ontario
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Windsor, Ontario, Kanada, N8W 1E3
- Windsor Regional Hosp., HIV Care Program CRS
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California
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San Francisco, California, Spojené státy, 94114
- Castro-Mission Health Ctr. CRS
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Colorado
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Denver, Colorado, Spojené státy, 80204-4507
- Univ. of Colorado Health Science Ctr. CRS
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Denver, Colorado, Spojené státy, 80205
- Eastside Family Health Ctr. CRS
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Denver, Colorado, Spojené státy, 80204
- Denver Public Health CRS
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Denver, Colorado, Spojené státy, 80204-4507
- Kaiser Permanente of Denver CRS
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Wheat Ridge, Colorado, Spojené státy, 80033
- Western Infectious Disease Consultants CRS
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District of Columbia
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Washington, District of Columbia, Spojené státy, 20422
- Washington DC VAMC, Washington Regional AIDS Program, Infectious Diseases CRS
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Florida
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Jacksonville, Florida, Spojené státy, 32206
- Univ. of Florida, Div. of Infectious Diseases CRS
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Louisiana
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Baton Rouge, Louisiana, Spojené státy, 70805
- Earl K. Long Med. Ctr., LSU - Mid City EIC Clinic CRS
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Michigan
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Detroit, Michigan, Spojené státy, 48202
- Henry Ford Hosp. CRS
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Detroit, Michigan, Spojené státy, 48201
- Wayne State Univ. CRS
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Lansing, Michigan, Spojené státy, 48910
- Michigan State Univ., Infectious Disease Clinic CRS
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New York
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Bronx, New York, Spojené státy, 10457
- Bronx-Lebanon Hosp. Ctr. CRS
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Bronx, New York, Spojené státy, 10461
- Jacobi Med. Ctr., Ambulatory Care Pavillion CRS
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Bronx, New York, Spojené státy, 10467
- Montefiore Med. Ctr., AIDS Ctr. CRS
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Bronx, New York, Spojené státy, 10468
- Bronx VAMC CRS
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Brooklyn, New York, Spojené státy, 11203
- SUNY Downstate Med. Ctr., HIV Ctr. for Women & Children CRS
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New York, New York, Spojené státy, 10037-1802
- Harlem Hospital Ctr./Columbia University CRS (Gordin CTU)
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Oklahoma
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Oklahoma City, Oklahoma, Spojené státy, 73104
- Univ. of Oklahoma Health Sciences Ctr., Div. of Infectious Diseases CRS
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Oregon
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Portland, Oregon, Spojené státy, 97227
- Kaiser Immune Deficiency Clinic of Portland CRS
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Portland, Oregon, Spojené státy, 97239
- Oregon Health & Sciences Univ. Internal Medicine (L-475) CRS
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Portland, Oregon, Spojené státy, 97210
- The Research & Education Group-Portland CRS
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Portland, Oregon, Spojené státy, 97227
- Legacy Clinic Emanuel CRS
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Pennsylvania
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Philadelphia, Pennsylvania, Spojené státy, 19140
- Temple Univ. School of Medicine CRS
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Virginia
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Fredericksburg, Virginia, Spojené státy, 22401
- MediCorp, Infectious Disease Associates CRS
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Richmond, Virginia, Spojené státy, 23298
- Virginia Commonwealth Univ. Medical Ctr. CRS
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Richmond, Virginia, Spojené státy, 23224
- CrossOver Health Ctr. CRS
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Richmond, Virginia, Spojené státy, 23298
- VCU Health Systems, Infectious Disease Clinic CRS
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Richmond, Virginia, Spojené státy, 23223
- Vernon Harris East End Community Health Ctr. CRS
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Wisconsin
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Milwaukee, Wisconsin, Spojené státy, 53226
- Med. College of Wisconsin, Infectious Disease Clinic CRS
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Chiang Mai, Thajsko
- Sanpatong Hosp. CRS
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Khon Kaen, Thajsko, 40002
- Khon Kaen Univ., Srinagarind Hosp., Div. of Infectious Diseases & Tropical Medicine, Dept. of Medici
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Nonthaburi
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Muang, Nonthaburi, Thajsko
- Bamrasnaradura Institute CRS
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Ratchathewi
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Bangkok, Ratchathewi, Thajsko
- Chulalongkorn University Hospital CRS
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Bangkok, Ratchathewi, Thajsko
- Mahidol Univ., Ramathibodi Hosp., Div of Infectious Disease CRS
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- Coenrollment in the SMART study
Exclusion Criteria:
- Unable to comply with all study requirements
Studijní plán
Jak je studie koncipována?
Detaily designu
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
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Change in QNPZ-5 scores
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time to development of symptomatic peripheral neuropathy
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change in peripheral neuropathy symptoms
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Sekundární výstupní opatření
Měření výsledku |
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Time to neurocognitive impairment
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time to development of ADC, stage 2 or greater
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chage in peripheral neuropathy symptoms
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time to development of asymptomatic or symptomatic peripheral neuropathy
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time to resolution of symptomatic peripheral neuropathy
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Spolupracovníci a vyšetřovatelé
Vyšetřovatelé
- Studijní židle: Edwina Wright, MBBS, FRACP, Infectious Disease Unit, the Alfred Hospital
Publikace a užitečné odkazy
Obecné publikace
- Morgello S, Estanislao L, Simpson D, Geraci A, DiRocco A, Gerits P, Ryan E, Yakoushina T, Khan S, Mahboob R, Naseer M, Dorfman D, Sharp V; Manhattan HIV Brain Bank. HIV-associated distal sensory polyneuropathy in the era of highly active antiretroviral therapy: the Manhattan HIV Brain Bank. Arch Neurol. 2004 Apr;61(4):546-51. doi: 10.1001/archneur.61.4.546.
- Sacktor N. The epidemiology of human immunodeficiency virus-associated neurological disease in the era of highly active antiretroviral therapy. J Neurovirol. 2002 Dec;8 Suppl 2:115-21. doi: 10.1080/13550280290101094.
- Antunes F. Central nervous system AIDS--related diseases. Acta Neurochir (Wien). 2004 Oct;146(10):1071-4. doi: 10.1007/s00701-004-0334-0.
- Verma S, Estanislao L, Simpson D. HIV-associated neuropathic pain: epidemiology, pathophysiology and management. CNS Drugs. 2005;19(4):325-34. doi: 10.2165/00023210-200519040-00005.
Užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
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
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- CPCRA 065F
- CPCRA 065
- CPCRA 065F1
- 10115 (DAIDS-ES)
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