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A Comparative Study of Combination Antiretroviral Therapy in Children and Adolescents With Advanced HIV Disease

To compare the antiviral activity, safety, toxicity, and steady-state pharmacokinetics of zidovudine, didanosine, and nevirapine used in combination in patients with HIV infection.

The duration of clinical benefit from zidovudine (AZT) may be limited because of development of viral resistance to the drug. Use of combination antiretroviral therapy can potentially reduce viral load and prevent emergence of multidrug resistance.

研究概览

详细说明

The duration of clinical benefit from zidovudine (AZT) may be limited because of development of viral resistance to the drug. Use of combination antiretroviral therapy can potentially reduce viral load and prevent emergence of multidrug resistance.

In Stage 1 of the study, a minimum of 22 patients are randomized to each of three treatment arms: didanosine (ddI) plus AZT plus nevirapine (NVP); ddI plus AZT; and ddI plus NVP. After 12 weeks of treatment, the study proceeds to Stage 2 provided at least 40 percent of patients in Stage 1 show a reduction of at least 40 percent from baseline ICD p24 antigen of greater than or equal to 70 pg/ml AND fewer than two patients experience grade 4 rash. Patients in Stage 1 continue treatment for an additional 36 weeks. In Stage 2, additional patients are randomized to each original treatment regimen until a maximum of 130 patients per arm have been entered. Stage 2 patients receive treatment for at least 48 weeks.

AS PER AMENDMENT 02/12/97: As of 2/28/97, patients receiving study drugs will be offered blinded study drugs for an additional 16 weeks (until 6/30/97). Patients will be unblinded on or about 5/23/97.

研究类型

介入性

注册

390

阶段

  • 阶段1

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Bayamon、波多黎各、00956
        • Ramon Ruiz Arnau Univ Hosp / Pediatrics
      • San Juan、波多黎各、009367344
        • San Juan City Hosp
      • San Juan、波多黎各、009365067
        • Univ of Puerto Rico / Univ Children's Hosp AIDS
    • Alabama
      • Birmingham、Alabama、美国、35294
        • Univ of Alabama at Birmingham Schl of Med / Pediatrics
    • California
      • La Jolla、California、美国、920930672
        • UCSD Med Ctr / Pediatrics / Clinical Sciences
      • Long Beach、California、美国、90801
        • Long Beach Memorial (Pediatric)
      • Los Angeles、California、美国、90033
        • Los Angeles County - USC Med Ctr
      • Los Angeles、California、美国、900481804
        • Cedars Sinai / UCLA Med Ctr
      • Los Angeles、California、美国、905022004
        • Harbor - UCLA Med Ctr / UCLA School of Medicine
      • Los Angeles、California、美国、900951752
        • UCLA Med Ctr / Pediatric
      • Oakland、California、美国、946091809
        • Children's Hosp of Oakland
      • San Francisco、California、美国、941430105
        • UCSF / Moffitt Hosp - Pediatric
    • Colorado
      • Denver、Colorado、美国、802181088
        • Children's Hosp of Denver
    • Connecticut
      • Farmington、Connecticut、美国、06032
        • Univ of Connecticut / Farmington
      • New Haven、Connecticut、美国、06504
        • Yale Univ Med School
    • District of Columbia
      • Washington、District of Columbia、美国、200102916
        • Children's Hosp of Washington DC
      • Washington、District of Columbia、美国、20060
        • Howard Univ Hosp
      • Washington、District of Columbia、美国、200072197
        • Georgetown Univ Med Ctr
    • Florida
      • Jacksonville、Florida、美国、32209
        • Univ of Florida Health Science Ctr / Pediatrics
      • Miami、Florida、美国、33161
        • Univ of Miami (Pediatric)
    • Georgia
      • Atlanta、Georgia、美国、30306
        • Emory Univ Hosp / Pediatrics
    • Illinois
      • Chicago、Illinois、美国、60612
        • Cook County Hosp
      • Chicago、Illinois、美国、606143394
        • Chicago Children's Memorial Hosp
      • Chicago、Illinois、美国、606371470
        • Univ of Chicago Children's Hosp
      • Chicago、Illinois、美国、60612
        • Univ of Illinois College of Medicine / Pediatrics
    • Louisiana
      • New Orleans、Louisiana、美国、701122699
        • Tulane Univ / Charity Hosp of New Orleans
    • Maryland
      • Baltimore、Maryland、美国、21201
        • Univ of Maryland at Baltimore / Univ Med Ctr
      • Baltimore、Maryland、美国、212874933
        • Johns Hopkins Hosp - Pediatric
    • Massachusetts
      • Boston、Massachusetts、美国、021155724
        • Children's Hosp of Boston
      • Springfield、Massachusetts、美国、01199
        • Baystate Med Ctr of Springfield
      • Worcester、Massachusetts、美国、016550001
        • Univ of Massachusetts Med School
    • Michigan
      • Detroit、Michigan、美国、48201
        • Children's Hosp of Michigan
    • New Jersey
      • New Brunswick、New Jersey、美国、089030019
        • UMDNJ - Robert Wood Johnson Med School / Pediatrics
      • Newark、New Jersey、美国、07103
        • Saint Joseph's Hosp and Med Ctr/UMDNJ - New Jersey Med Schl
    • New York
      • Albany、New York、美国、12208
        • Children's Hosp at Albany Med Ctr
      • Bronx、New York、美国、10457
        • Bronx Lebanon Hosp Ctr
      • Bronx、New York、美国、10461
        • Bronx Municipal Hosp Ctr / Bronx Lebanon Hosp Ctr
      • Brooklyn、New York、美国、11203
        • King's County Hosp Ctr / Pediatrics
      • Brooklyn、New York、美国、11203
        • SUNY - Brooklyn
      • Great Neck、New York、美国、11021
        • North Shore Univ Hosp
      • New Hyde Park、New York、美国、11040
        • Schneider Children's Hosp
      • New York、New York、美国、10016
        • Bellevue Hosp / New York Univ Med Ctr
      • New York、New York、美国、10029
        • Metropolitan Hosp Ctr
      • New York、New York、美国、10021
        • Cornell Univ Med College
      • New York、New York、美国、10032
        • Columbia Presbyterian Med Ctr
      • New York、New York、美国、10032
        • Incarnation Children's Ctr / Columbia Presbyterian Med Ctr
      • New York、New York、美国、10037
        • Harlem Hosp Ctr
      • New York、New York、美国、10029
        • Mount Sinai Med Ctr / Pediatrics
      • New York、New York、美国、10003
        • Beth Israel Med Ctr / Pediatrics
      • New York、New York、美国、10029
        • Mount Sinai Med Ctr / Hemophilia Treatment Ctr
      • Rochester、New York、美国、14642
        • Univ of Rochester Medical Center
      • Stony Brook、New York、美国、117948111
        • State Univ of New York at Stony Brook
      • Syracuse、New York、美国、13210
        • SUNY Health Sciences Ctr at Syracuse / Pediatrics
      • Valhalla、New York、美国、10595
        • Westchester Hosp
    • North Carolina
      • Durham、North Carolina、美国、277103499
        • Duke Univ Med Ctr
      • Durham、North Carolina、美国、27710
        • Univ of North Carolina at Chapel Hill / Duke Univ Med Ctr
    • Ohio
      • Columbus、Ohio、美国、432052696
        • Columbus Children's Hosp
      • Dayton、Ohio、美国、454041815
        • West Central Ohio Hemophilia Ctr / Children's Med Ctr
    • Pennsylvania
      • Hershey、Pennsylvania、美国、170330850
        • Milton S Hershey Med Ctr
      • Hershey、Pennsylvania、美国、170330850
        • Univ of Pittsburgh Med School / Hershey Med Ctr
      • Philadelphia、Pennsylvania、美国、191044318
        • Children's Hosp of Philadelphia
      • Philadelphia、Pennsylvania、美国、191341095
        • Saint Christopher's Hosp for Children
    • Rhode Island
      • Providence、Rhode Island、美国、02903
        • Rhode Island Hosp / Brown Univ
    • South Carolina
      • Charleston、South Carolina、美国、294253312
        • Med Univ of South Carolina
    • Texas
      • Dallas、Texas、美国、75235
        • Children's Med Ctr of Dallas
      • Houston、Texas、美国、77030
        • Texas Children's Hosp / Baylor Univ
    • Virginia
      • Norfolk、Virginia、美国、23507
        • Children's Hosp of the King's Daughters
    • Washington
      • Seattle、Washington、美国、981050371
        • Children's Hospital & Medical Center / Seattle ACTU

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

6个月 至 20年 (孩子、成人)

接受健康志愿者

有资格学习的性别

全部

描述

Inclusion Criteria

Concurrent Medication:

Allowed:

  • Erythropoietin.

Concurrent Treatment:

Allowed:

  • Transfusion.

Patients must have:

  • Progressive HIV disease.
  • At least 24 weeks prior cumulative nucleoside analog antiretroviral monotherapy or combination therapy.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

  • Active malignancy requiring chemotherapy.
  • Currently receiving therapy in an ACTG primary therapy or salvage protocol who have NOT met an endpoint on that study.
  • Known intolerance (other than hematologic) or toxicity to ddI, AZT, or NVP at the doses used in this study.

Concurrent Medication:

Excluded (unless exemption made by study chair):

  • Oral anticoagulants (warfarin, dicumarol).
  • Oral contraceptives.
  • Digitalis glycosides.
  • Phenytoin.
  • Theophylline.

Patients with the following prior conditions are excluded:

  • History of clinical pancreatitis.
  • History of grade 2 or worse peripheral neuropathy.

Prior Treatment:

Excluded:

  • Acute treatment for a serious bacterial, viral, or opportunistic infection within 14 days prior to study entry.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 学习椅:Burchett S
  • 学习椅:Luzuriaga K

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

  • Perrier M, Schwarz T, Gonzalez O, Brounts S. Squamous cell carcinoma invading the right temporomandibular joint in a Belgian mare. Can Vet J. 2010 Aug;51(8):885-7.
  • McKinney RE Jr. Ongoing and future trials of antiretroviral therapy in the pediatric AIDS clinical trials group (PACTG). Conf Retroviruses Opportunistic Infect. 1996 Jan 28-Feb 1;3rd:173
  • Burchett SK, Carey V, Yong F, Sullivan J, Sulzbacher S, Civitello L, Culnane M, Mofenson L, Siminski S, Robinson P, Luzuriaga K. Virologic activity of didanosine (ddI), zidovudine (ZDV) and nevirapine (NVP) combinations in pediatric subjects with advanced HIV disease (ACTG 245). Conf Retroviruses Opportunistic Infect. 1998 Feb 1-5;5th:130 (abstract no 271)
  • Burchett S, Sullivan J, Luzuriaga K, Carey V, Yong F, Culnane M, Mofenson L, Robinson P. Combinations of didanosine (DDI), zidovudine (ZDV) and nevirapine (NVP) can reduce CSF HIV-1 viral load in pediatric patients with advanced HIV disease. Int Conf AIDS. 1998;12:62 (abstract no 12253)

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

研究完成 (实际的)

1998年11月1日

研究注册日期

首次提交

1999年11月2日

首先提交符合 QC 标准的

2001年8月30日

首次发布 (估计)

2001年8月31日

研究记录更新

最后更新发布 (实际的)

2021年10月28日

上次提交的符合 QC 标准的更新

2021年10月27日

最后验证

2021年10月1日

更多信息

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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