- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT00001025
Evaluation of Patients Who Have Not Had Success With Zidovudine
A Study to Evaluate the Short-Term Clinical and Virologic Significance of Zidovudine Resistance
To determine the relationship of viral susceptibility to zidovudine (AZT) and baseline viral load (as determined by plasma viremia and quantitative endpoint dilution). To determine the relationship between viral load and susceptibility during different antiretroviral therapy strategies. To correlate measures of viral load and short term clinical and laboratory markers (such as weight, CD4 count, p24 antigenemia, and beta2 microglobulin) on the different therapy arms.
High-grade resistance to AZT has been detected in HIV isolates from approximately 25 percent of individuals with AIDS who received AZT for at least 1 year. To elucidate the clinical significance of in vitro AZT resistance, it is necessary to distinguish between clinical failure caused by AZT resistance and clinical decompensation caused by other factors.
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
High-grade resistance to AZT has been detected in HIV isolates from approximately 25 percent of individuals with AIDS who received AZT for at least 1 year. To elucidate the clinical significance of in vitro AZT resistance, it is necessary to distinguish between clinical failure caused by AZT resistance and clinical decompensation caused by other factors.
One hundred-twenty patients who have been receiving AZT for at least 1 year are randomized to 1) continue with AZT, 2) switch to treatment with didanosine at 1 of 2 doses, or 3) receive both AZT and ddI. Treatment is given for 16 weeks, with a possible extension to 32 weeks. Patients are followed at weeks 2, 4, 8, 12, and 16. For analysis purposes only, patients are stratified according to degree of susceptibility of HIV isolates to AZT.
Studietype
Registrering
Fase
- Fase 2
Kontakter og plasseringer
Studiesteder
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Alabama
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Birmingham, Alabama, Forente stater, 35294
- Univ of Alabama at Birmingham
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California
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San Francisco, California, Forente stater, 941102859
- San Francisco Gen Hosp
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San Jose, California, Forente stater, 951282699
- Santa Clara Valley Med Ctr / AIDS Community Rsch Consortium
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Stanford, California, Forente stater, 943055107
- San Mateo AIDS Program / Stanford Univ
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Colorado
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Denver, Colorado, Forente stater, 80262
- Univ of Colorado Health Sciences Ctr
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Denver, Colorado, Forente stater, 80262
- Kaiser Permanente Franklin Med Ctr
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Illinois
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Chicago, Illinois, Forente stater, 60611
- Northwestern Univ Med School
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Chicago, Illinois, Forente stater, 60612
- Rush Presbyterian - Saint Luke's Med Ctr
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Chicago, Illinois, Forente stater, 60612
- Cook County Hosp
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Chicago, Illinois, Forente stater, 60611
- Children's Mem Hosp Family Cln / Northwestern Univ Med Schl
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Massachusetts
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Springfield, Massachusetts, Forente stater, 01199
- Baystate Med Ctr of Springfield
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Minnesota
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Minneapolis, Minnesota, Forente stater, 55455
- Univ of Minnesota
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Nebraska
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Omaha, Nebraska, Forente stater, 681985130
- Univ of Nebraska Med Ctr
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New York
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Brooklyn, New York, Forente stater, 112032098
- SUNY / Health Sciences Ctr at Brooklyn
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Buffalo, New York, Forente stater, 14215
- SUNY / Erie County Med Ctr at Buffalo
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Rochester, New York, Forente stater, 14642
- Univ of Rochester Medical Center
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Syracuse, New York, Forente stater, 13210
- SUNY / State Univ of New York
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Washington
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Seattle, Washington, Forente stater, 981224304
- Univ of Washington
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria
Concurrent Medication:
Allowed:
- Chemoprophylaxis against Pneumocystis carinii pneumonia (PCP), Mycobacterium tuberculosis, or Herpes simplex virus, or against other opportunistic infections as indicated.
- Corticosteroids for no longer than 21 days (only as part of PCP therapy).
- Erythropoietin and G-CSF.
Patients must have:
- Documented HIV-seropositivity.
- CD4 count 100 - 300 cells/mm3.
- Prior continuous AZT dose = or > 300 mg/day for 1 year or longer.
Prior Medication: Required:
- AZT for at least 1 year prior to study entry.
Exclusion Criteria
Co-existing Condition:
Patients with the following symptoms and conditions are excluded:
- Medical contraindication or is considered noncompliant in the opinion of the investigator.
- Peripheral neuropathy = or > grade 2.
Concurrent Medication:
Excluded:
- Anti-HIV agents other than study drugs.
- Biologic response modifiers (other than erythropoietin or G-CSF).
- Systemic cytotoxic chemotherapy.
- Regularly prescribed medications (such as antipyretics, analgesics, allergy medications) that are associated with an increased risk of pancreatitis, peripheral neuropathy, or bone marrow suppression.
Concurrent Treatment:
Excluded:
- Radiation therapy.
Patients with the following prior conditions are excluded:
- History of acute or chronic pancreatitis, gout, or uric acid nephropathy.
Prior Medication:
Excluded:
- Other antiretrovirals besides AZT.
- ddI or ddC for more than 30 days within the past year or any time within 3 months prior to study entry.
- Acute therapy for an infection or other medical illness within 14 days prior to study entry.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
Samarbeidspartnere og etterforskere
Etterforskere
- Studiestol: Coombs R
- Studiestol: Cavert W
Publikasjoner og nyttige lenker
Generelle publikasjoner
- Cavert W, Coombs RW, Kuritzkes D, Grimes J, Stein D, Rojo W, Beatty C, Winters M, Corey L. Baseline zidovudine (ZDV) susceptibility, codon 215 mutation, viral load and syncytium-inducting characteristics(SI) of HIV isolates from ACTG protocol 194. Natl Conf Hum Retroviruses Relat Infect (1st). 1993 Dec 12-16:137
- Reichelderfer PS, Coombs RW. Multifactorial analysis of the inverse relationship between viral load and CD4+ cell count. Int Conf AIDS. 1996 Jul 7-12;11(2):277 (abstract no ThB4148)
Studierekorddatoer
Studer hoveddatoer
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- RNA-virusinfeksjoner
- Virussykdommer
- Infeksjoner
- Blodbårne infeksjoner
- Smittsomme sykdommer
- Seksuelt overførbare sykdommer, virale
- Seksuelt overførbare sykdommer
- Lentivirus infeksjoner
- Retroviridae-infeksjoner
- Immunologiske mangelsyndromer
- Sykdommer i immunsystemet
- HIV-infeksjoner
- Molekylære mekanismer for farmakologisk virkning
- Anti-infeksjonsmidler
- Antivirale midler
- Revers transkriptasehemmere
- Nukleinsyresyntesehemmere
- Enzymhemmere
- Anti-HIV-midler
- Antiretrovirale midler
- Antimetabolitter
- Zidovudin
- Didanosin
Andre studie-ID-numre
- ACTG 194
- 11170 (Registeridentifikator: DAIDS ES Registry Number)
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .
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