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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.

Przegląd badań

Status

Zakończony

Szczegółowy opis

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 studiów

Interwencyjne

Zapisy

1500

Faza

  • Faza 2

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

      • San Juan, Portoryko, 009275800
        • San Juan Veterans Administration Med Ctr
    • California
      • Los Angeles, California, Stany Zjednoczone, 900276016
        • Children's Hosp of Los Angeles/UCLA Med Ctr
      • Los Angeles, California, Stany Zjednoczone, 90033
        • Los Angeles County - USC Med Ctr
      • Palo Alto, California, Stany Zjednoczone, 94304
        • Palo Alto Veterans Adm Med Ctr / Stanford Univ
      • San Diego, California, Stany Zjednoczone, 921036325
        • Univ of California / San Diego Treatment Ctr
      • Stanford, California, Stany Zjednoczone, 94305
        • Stanford Univ School of Medicine
      • Sylmar, California, Stany Zjednoczone, 91342
        • Olive View Med Ctr
      • Sylmar, California, Stany Zjednoczone, 91342
        • Sepulveda Veterans Adm Med Ctr / Olive View Med Ctr
      • Torrance, California, Stany Zjednoczone, 90502
        • Harbor UCLA Med Ctr
    • Colorado
      • Denver, Colorado, Stany Zjednoczone, 80262
        • Univ of Colorado Health Sciences Ctr
      • Denver, Colorado, Stany Zjednoczone, 80262
        • Mountain States Regional Hemophilia Ctr / Univ of Colorado
    • District of Columbia
      • Washington, District of Columbia, Stany Zjednoczone, 20037
        • George Washington Univ Med Ctr
      • Washington, District of Columbia, Stany Zjednoczone, 20009
        • Whitman - Walker Clinic
    • Florida
      • Fort Lauderdale, Florida, Stany Zjednoczone, 33316
        • G E Morey Jr
      • Miami, Florida, Stany Zjednoczone, 331361013
        • Univ of Miami School of Medicine
    • Illinois
      • Chicago, Illinois, Stany Zjednoczone, 60611
        • Northwestern Univ Med School
      • Chicago, Illinois, Stany Zjednoczone, 60612
        • Rush Presbyterian - Saint Luke's Med Ctr
      • Chicago, Illinois, Stany Zjednoczone, 60612
        • Cook County Hosp
      • Hines, Illinois, Stany Zjednoczone, 60141
        • Edward Hines Veterans Administration Hosp
    • Indiana
      • Indianapolis, Indiana, Stany Zjednoczone, 462025250
        • Indiana Univ Hosp
    • Kansas
      • Wichita, Kansas, Stany Zjednoczone, 67214
        • Univ of Kansas School of Medicine
    • Louisiana
      • New Orleans, Louisiana, Stany Zjednoczone, 70112
        • Louisiana Comprehensive Hemophilia Care Ctr
      • New Orleans, Louisiana, Stany Zjednoczone, 70112
        • Louisiana State Univ Med Ctr / Tulane Med School
      • New Orleans, Louisiana, Stany Zjednoczone, 70112
        • Tulane Univ School of Medicine
      • New Orleans, Louisiana, Stany Zjednoczone, 70112
        • Charity Hosp / Tulane Univ Med School
    • Maryland
      • Baltimore, Maryland, Stany Zjednoczone, 21287
        • Johns Hopkins Hosp
    • Massachusetts
      • Boston, Massachusetts, Stany Zjednoczone, 02114
        • Harvard (Massachusetts Gen Hosp)
      • Boston, Massachusetts, Stany Zjednoczone, 02118
        • Boston Med Ctr
      • Boston, Massachusetts, Stany Zjednoczone, 02215
        • Beth Israel Deaconess - West Campus
      • Boston, Massachusetts, Stany Zjednoczone, 02215
        • Beth Israel Deaconess Med Ctr
      • Springfield, Massachusetts, Stany Zjednoczone, 01199
        • Baystate Med Ctr of Springfield
      • Worcester, Massachusetts, Stany Zjednoczone, 01605
        • Med Ctr of Central Massachusetts
      • Worcester, Massachusetts, Stany Zjednoczone, 01655
        • Univ of Massachusetts Med Ctr
    • Minnesota
      • Minneapolis, Minnesota, Stany Zjednoczone, 55455
        • Univ of Minnesota
    • Nebraska
      • Omaha, Nebraska, Stany Zjednoczone, 68105
        • Nebraska Regional Hemophilia Ctr
    • New York
      • Bronx, New York, Stany Zjednoczone, 10461
        • Bronx Municipal Hosp Ctr/Jacobi Med Ctr
      • Bronx, New York, Stany Zjednoczone, 10465
        • Jack Weiler Hosp / Bronx Municipal Hosp
      • Bronx, New York, Stany Zjednoczone, 10467
        • Montefiore Med Ctr / Bronx Municipal Hosp
      • Bronx, New York, Stany Zjednoczone, 10468
        • Bronx Veterans Administration / Mount Sinai Hosp
      • Buffalo, New York, Stany Zjednoczone, 14215
        • SUNY / Erie County Med Ctr at Buffalo
      • Elmhurst, New York, Stany Zjednoczone, 11373
        • City Hosp Ctr at Elmhurst / Mount Sinai Hosp
      • New York, New York, Stany Zjednoczone, 10021
        • Cornell Univ Med Ctr
      • New York, New York, Stany Zjednoczone, 10003
        • Beth Israel Med Ctr / Peter Krueger Clinic
      • New York, New York, Stany Zjednoczone, 10016
        • Bellevue Hosp / New York Univ Med Ctr
      • New York, New York, Stany Zjednoczone, 10021
        • Mem Sloan - Kettering Cancer Ctr
      • New York, New York, Stany Zjednoczone, 10025
        • Saint Luke's - Roosevelt Hosp Ctr
      • New York, New York, Stany Zjednoczone, 10029
        • Mount Sinai Med Ctr
      • Rochester, New York, Stany Zjednoczone, 14642
        • Univ of Rochester Medical Center
      • Stony Brook, New York, Stany Zjednoczone, 117948153
        • SUNY - Stony Brook
      • Syracuse, New York, Stany Zjednoczone, 13210
        • SUNY / State Univ of New York
    • North Carolina
      • Chapel Hill, North Carolina, Stany Zjednoczone, 275997215
        • Univ of North Carolina
      • Durham, North Carolina, Stany Zjednoczone, 27710
        • Duke Univ Med Ctr
      • Winston-Salem, North Carolina, Stany Zjednoczone, 27103
        • Bowman Gray School of Medicine / Wake Forest Univ
    • Ohio
      • Cincinnati, Ohio, Stany Zjednoczone, 452670405
        • Holmes Hosp / Univ of Cincinnati Med Ctr
      • Columbus, Ohio, Stany Zjednoczone, 432101228
        • Ohio State Univ Hosp Clinic
      • Toledo, Ohio, Stany Zjednoczone, 43699
        • Med College of Ohio
    • Pennsylvania
      • Hershey, Pennsylvania, Stany Zjednoczone, 170330850
        • Milton S Hershey Med Ctr
      • Philadelphia, Pennsylvania, Stany Zjednoczone, 19104
        • Univ of Pennsylvania
      • Pittsburgh, Pennsylvania, Stany Zjednoczone, 15219
        • Hemophilia Ctr of Western PA / Univ of Pittsburgh
      • Pittsburgh, Pennsylvania, Stany Zjednoczone
        • Univ of Pittsburgh Med School
    • South Carolina
      • West Columbia, South Carolina, Stany Zjednoczone, 29169
        • Julio Arroyo
    • Tennessee
      • Knoxville, Tennessee, Stany Zjednoczone, 37920
        • Univ of Tennessee / E Tennessee Comprehensive Hemophilia Ctr
    • Texas
      • Galveston, Texas, Stany Zjednoczone, 77550
        • Univ TX Galveston Med Branch
      • Houston, Texas, Stany Zjednoczone, 77030
        • Hermann Hosp / Univ Texas Health Science Ctr
      • Houston, Texas, Stany Zjednoczone, 77030
        • Texas Children's Hosp / Baylor Univ
    • Utah
      • Salt Lake City, Utah, Stany Zjednoczone, 84132
        • Univ of Utah School of Medicine
    • Virginia
      • Hampton, Virginia, Stany Zjednoczone, 23666
        • Dr Stephen L Green
    • Washington
      • Seattle, Washington, Stany Zjednoczone, 98105
        • Univ of Washington
    • Wisconsin
      • Milwaukee, Wisconsin, Stany Zjednoczone, 53215
        • Dr Brian Buggy
      • Milwaukee, Wisconsin, Stany Zjednoczone, 53226
        • Milwaukee County Med Complex
      • Milwaukee, Wisconsin, Stany Zjednoczone, 53233
        • Great Lakes Hemophilia Foundation

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

12 lat i starsze (Dziecko, Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

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.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Współpracownicy

Śledczy

  • Krzesło do nauki: R Dolin

Publikacje i pomocne linki

Osoba odpowiedzialna za wprowadzenie informacji o badaniu dobrowolnie udostępnia te publikacje. Mogą one dotyczyć wszystkiego, co jest związane z badaniem.

Publikacje ogólne

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów

7 grudnia 2022

Zakończenie podstawowe (Rzeczywisty)

1 października 1992

Ukończenie studiów

7 grudnia 2022

Daty rejestracji na studia

Pierwszy przesłany

2 listopada 1999

Pierwszy przesłany, który spełnia kryteria kontroli jakości

30 sierpnia 2001

Pierwszy wysłany (Oszacować)

31 sierpnia 2001

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Oszacować)

14 marca 2011

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

11 marca 2011

Ostatnia weryfikacja

1 stycznia 2003

Więcej informacji

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

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