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A Pharmacologically Guided Phase I/II Study of Daily Orally Administered Synthetic Hypericin in HIV-Infected Subjects

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Hypericin
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Administration, Oral, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Antiviral Agents

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria Concurrent Medication: Required: PCP prophylaxis. Allowed: Rifabutin, ketoconazole, fluconazole, and acyclovir, provided the medication has been taken for at least 4 weeks prior to study entry without toxicity. Topical medications such as clotrimazole troches or nystatin suspension. Patients must have: Documented HIV infection. CD4 count <= 350 cells/mm3. p24 antigen positive at >= 35 pcg/ml. No active opportunistic infection at study entry that would require curative or suppressive therapy. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Malignancy for which systemic chemotherapy is required. Medically significant liver disease, orthostatic hypotension, hypertension, cardiac disease, seizure disorders, or lymphoma. Any medical condition that would interfere with evaluation of the patient. Concurrent Medication: Excluded: AZT, ddI, ddC, d4T, or any other antiretroviral medication. Interferon or other immunomodulating drugs. Cytotoxic chemotherapy. Foscarnet. Ganciclovir. Antimycobacterial drugs other than rifabutin. MAO inhibitors. Hypertension-inducing, nephrotoxic, or hepatotoxic drugs. Opiates. Drugs known to cause photosensitivity. Prior Medication: Excluded within 1 month prior to study entry: AZT, ddI, ddC, d4T, or any other antiretroviral medication. Interferon or other immunomodulating drugs. Cytotoxic chemotherapy. Preparations known to contain hypericin. Excluded within 3 months prior to study entry: Ribavirin. Hyperforate (500 mg tablets or ampules for IV injection) manufactured by Kline. Psychotonin M Alcohol Extract manufactured by Steigerwald. Hypericin (40 mg vial) by VIMRx. Excluded within 14 days prior to study entry: Foscarnet. Ganciclovir. Antimycobacterial drugs other than rifabutin. MAO inhibitors. Hypertension-inducing, nephrotoxic, or hepatotoxic drugs.

Sites / Locations

  • Johns Hopkins Adult AIDS CRS
  • Beth Israel Deaconess - East Campus A0102 CRS
  • NY Univ. HIV/AIDS CRS

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
October 27, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
VIMRx Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00000792
Brief Title
A Pharmacologically Guided Phase I/II Study of Daily Orally Administered Synthetic Hypericin in HIV-Infected Subjects
Official Title
A Pharmacologically Guided Phase I/II Study of Daily Orally Administered Synthetic Hypericin in HIV-Infected Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
undefined (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
January 1995 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
VIMRx Pharmaceuticals

4. Oversight

5. Study Description

Brief Summary
To determine the safety and tolerance of daily oral hypericin when given to achieve target trough levels within defined cohorts. To determine the responses of surrogate markers of HIV infection to daily oral hypericin. It is not known whether daily oral dosing will produce a tolerable prolonged exposure to therapeutic levels of hypericin. Pharmacokinetic modeling studies have demonstrated that daily oral dosing should produce a trough level in a desired range without excessive peak levels.
Detailed Description
It is not known whether daily oral dosing will produce a tolerable prolonged exposure to therapeutic levels of hypericin. Pharmacokinetic modeling studies have demonstrated that daily oral dosing should produce a trough level in a desired range without excessive peak levels. Cohorts of six patients each receive escalating doses of oral hypericin daily. Blood is sampled for peak and trough levels the second week of therapy. A computer modeling algorithm will use these levels to determine the appropriate dose needed for each patient to achieve the desired trough level. When three of six patients at a given dose have completed 3 weeks of therapy without evidence of dose-limiting toxicity, data will be reviewed to determine whether subsequent patients should be entered at the next higher dose. The MTD is defined as the dose level immediately below that at which grade 3 or worse toxicity is seen in three or more of six patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Administration, Oral, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Antiviral Agents

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Masking
None (Open Label)
Enrollment
24 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Hypericin

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Required: PCP prophylaxis. Allowed: Rifabutin, ketoconazole, fluconazole, and acyclovir, provided the medication has been taken for at least 4 weeks prior to study entry without toxicity. Topical medications such as clotrimazole troches or nystatin suspension. Patients must have: Documented HIV infection. CD4 count <= 350 cells/mm3. p24 antigen positive at >= 35 pcg/ml. No active opportunistic infection at study entry that would require curative or suppressive therapy. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Malignancy for which systemic chemotherapy is required. Medically significant liver disease, orthostatic hypotension, hypertension, cardiac disease, seizure disorders, or lymphoma. Any medical condition that would interfere with evaluation of the patient. Concurrent Medication: Excluded: AZT, ddI, ddC, d4T, or any other antiretroviral medication. Interferon or other immunomodulating drugs. Cytotoxic chemotherapy. Foscarnet. Ganciclovir. Antimycobacterial drugs other than rifabutin. MAO inhibitors. Hypertension-inducing, nephrotoxic, or hepatotoxic drugs. Opiates. Drugs known to cause photosensitivity. Prior Medication: Excluded within 1 month prior to study entry: AZT, ddI, ddC, d4T, or any other antiretroviral medication. Interferon or other immunomodulating drugs. Cytotoxic chemotherapy. Preparations known to contain hypericin. Excluded within 3 months prior to study entry: Ribavirin. Hyperforate (500 mg tablets or ampules for IV injection) manufactured by Kline. Psychotonin M Alcohol Extract manufactured by Steigerwald. Hypericin (40 mg vial) by VIMRx. Excluded within 14 days prior to study entry: Foscarnet. Ganciclovir. Antimycobacterial drugs other than rifabutin. MAO inhibitors. Hypertension-inducing, nephrotoxic, or hepatotoxic drugs.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Valentine FT
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Crumpacker C
Official's Role
Study Chair
Facility Information:
Facility Name
Johns Hopkins Adult AIDS CRS
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Beth Israel Deaconess - East Campus A0102 CRS
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
NY Univ. HIV/AIDS CRS
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Furner V, Bek M, Gold J. A Phase I/II unblinded dose ranging study of hypericin in HIV-positive subjects. Int Conf AIDS. 1991 Jun 16-21;7(2):199 (abstract no WB2071)
Results Reference
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PubMed Identifier
10075619
Citation
Gulick RM, McAuliffe V, Holden-Wiltse J, Crumpacker C, Liebes L, Stein DS, Meehan P, Hussey S, Forcht J, Valentine FT. Phase I studies of hypericin, the active compound in St. John's Wort, as an antiretroviral agent in HIV-infected adults. AIDS Clinical Trials Group Protocols 150 and 258. Ann Intern Med. 1999 Mar 16;130(6):510-4. doi: 10.7326/0003-4819-130-6-199903160-00015.
Results Reference
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A Pharmacologically Guided Phase I/II Study of Daily Orally Administered Synthetic Hypericin in HIV-Infected Subjects

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