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A Study of Dideoxycytidine Plus Zidovudine in the Treatment of AIDS or Advanced AIDS Related Complex (ARC)

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Zidovudine
Zalcitabine
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 Zalcitabine, Drug Therapy, Combination, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Zidovudine

Eligibility Criteria

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

Inclusion Criteria Concurrent Medication: Allowed: Aerosolized pentamidine 300 mg per 4 weeks. Drugs unlikely to cause increased toxicity with either study drug and unlikely to cause peripheral neuropathy. Drugs with little nephrotoxicity, hepatotoxicity, or cytotoxicity, that patient has been taking and tolerating well for ongoing condition. Acyclovir (= or < 600 mg/day, orally). Ketoconazole (= or < 400 mg/day). Nystatin (occasional). Acetaminophen or nonsteroidal antiinflammatory agents (low dose). Drugs that could possibly cause serious additive toxicity when coadministered with either study drug, but unlikely to cause peripheral are allowed only if their use is anticipated for treatment of acute intercurrent illness or opportunistic infections. Allowed only with a study drug interruption of up to 21 days per episode, for a total of 42 days for the study: Acyclovir (> 600 mg/day). Experimental drugs including ganciclovir. Fluconazole. Systemic pentamidine. Pyrimethamine. Triple sulfa. Ansamycin. Prolonged continuous use of high-dose nonsteroidal antiinflammatory agents. Acetaminophen. Amphotericin. Foscarnet. Concurrent Treatment: Allowed: Radiation therapy if unlikely to cause peripheral neuropathy if their use is anticipated for treatment of acute intercurrent illness or opportunistic infection. Transfusion for anemia. Exclusion Criteria Co-existing Condition: Patients with the following are excluded: Active opportunistic infections requiring treatment with unallowed drugs. Symptomatic visceral Kaposi's sarcoma (KS), progression of KS within month prior to study entry, or with concurrent neoplasms other than KS, basal cell carcinoma of the skin, or in situ carcinoma of the cervix. History of peripheral neuropathy or any significant signs or symptoms of neurological disease, or abnormality indicative of peripheral neuropathy. Significant cardiac disease defined as history of ventricular arrhythmias requiring medication, prior myocardial infarction, or history of angina or ischemic changes on electrocardiogram. Significant liver disease as defined by transaminase levels or by history of cirrhosis or ascites. Significant renal disease defined by serum creatinine. Concurrent Medication: Excluded: Experimental drugs including fluconazole, and foscarnet. Immunomodulators including interferon, interleukins, or systemic corticosteroids. Ganciclovir. Neurotoxic drugs. Drugs that could potentially cause peripheral neuropathy, including chloramphenicol, cisplatin, iodoquinol, dapsone, phenytoin, disulfiram, ethionamide, glutethimide, gold, hydralazine, isoniazid, metronidazole, vincristine, and nitrofurantoin. Excluded within 4 weeks of study entry: Drugs that have caused significant nephrotoxicity or significant hepatotoxicity (as defined by transaminases). Concurrent Treatment: Excluded: Transfusion dependent. Patients are excluded if unwilling or unable to sign informed consent. Prior Medication: Excluded: Zidovudine (AZT). Dideoxycytidine (ddC). Any other nucleoside antiretrovirals. Positive antibody to HIV using any federally licensed ELISA test kit. Diagnosis of AIDS or AIDS-related complex (ARC). Active substance or alcohol abuse.

Sites / Locations

  • Univ of California / San Diego Treatment Ctr
  • Univ of Miami School of Medicine

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
August 6, 2008
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT00000978
Brief Title
A Study of Dideoxycytidine Plus Zidovudine in the Treatment of AIDS or Advanced AIDS Related Complex (ARC)
Official Title
An Open-Label, Randomized, Dose-Finding, Multicenter Trial of Dideoxycytidine (ddC) Administered Concurrently With Zidovudine (AZT) in the Treatment of AIDS or Advanced ARC
Study Type
Interventional

2. Study Status

Record Verification Date
August 1992
Overall Recruitment Status
Completed
Study Start Date
undefined (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Hoffmann-La Roche

4. Oversight

5. Study Description

Brief Summary
To determine the safety, tolerability, and activity of zidovudine (AZT) and zalcitabine (dideoxycytidine; ddC) and the bloodstream levels of these drugs in patients with AIDS or advanced AIDS-related complex (ARC). Treatments using AZT alternating with ddC are being evaluated in ongoing trials with a goal of reducing the toxicity of each while maintaining antiviral effects. In addition, AZT and ddC may work together in a way that both drugs can be taken at lower doses or less frequent intervals when given together. If the doses can be reduced, then toxicity associated with long-term use of one drug may be reduced. Combination of AZT and ddC might reduce the likelihood of the emergence of resistant mutants. Recent studies indicate a reduced sensitivity of HIV isolated from patients after prolonged AZT therapy. Although the clinical significance of this finding is not clear, it would indicate that these combination studies are all the more important. HIV strains with decreased sensitivity to AZT are still sensitive to ddC.
Detailed Description
Treatments using AZT alternating with ddC are being evaluated in ongoing trials with a goal of reducing the toxicity of each while maintaining antiviral effects. In addition, AZT and ddC may work together in a way that both drugs can be taken at lower doses or less frequent intervals when given together. If the doses can be reduced, then toxicity associated with long-term use of one drug may be reduced. Combination of AZT and ddC might reduce the likelihood of the emergence of resistant mutants. Recent studies indicate a reduced sensitivity of HIV isolated from patients after prolonged AZT therapy. Although the clinical significance of this finding is not clear, it would indicate that these combination studies are all the more important. HIV strains with decreased sensitivity to AZT are still sensitive to ddC. Patients are randomly assigned to one of six treatment groups of various dose combinations of AZT and ddC. Patients are evaluated every week for the first 10 weeks and biweekly thereafter.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Zalcitabine, Drug Therapy, Combination, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Zidovudine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Enrollment
68 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Zidovudine
Intervention Type
Drug
Intervention Name(s)
Zalcitabine

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed: Aerosolized pentamidine 300 mg per 4 weeks. Drugs unlikely to cause increased toxicity with either study drug and unlikely to cause peripheral neuropathy. Drugs with little nephrotoxicity, hepatotoxicity, or cytotoxicity, that patient has been taking and tolerating well for ongoing condition. Acyclovir (= or < 600 mg/day, orally). Ketoconazole (= or < 400 mg/day). Nystatin (occasional). Acetaminophen or nonsteroidal antiinflammatory agents (low dose). Drugs that could possibly cause serious additive toxicity when coadministered with either study drug, but unlikely to cause peripheral are allowed only if their use is anticipated for treatment of acute intercurrent illness or opportunistic infections. Allowed only with a study drug interruption of up to 21 days per episode, for a total of 42 days for the study: Acyclovir (> 600 mg/day). Experimental drugs including ganciclovir. Fluconazole. Systemic pentamidine. Pyrimethamine. Triple sulfa. Ansamycin. Prolonged continuous use of high-dose nonsteroidal antiinflammatory agents. Acetaminophen. Amphotericin. Foscarnet. Concurrent Treatment: Allowed: Radiation therapy if unlikely to cause peripheral neuropathy if their use is anticipated for treatment of acute intercurrent illness or opportunistic infection. Transfusion for anemia. Exclusion Criteria Co-existing Condition: Patients with the following are excluded: Active opportunistic infections requiring treatment with unallowed drugs. Symptomatic visceral Kaposi's sarcoma (KS), progression of KS within month prior to study entry, or with concurrent neoplasms other than KS, basal cell carcinoma of the skin, or in situ carcinoma of the cervix. History of peripheral neuropathy or any significant signs or symptoms of neurological disease, or abnormality indicative of peripheral neuropathy. Significant cardiac disease defined as history of ventricular arrhythmias requiring medication, prior myocardial infarction, or history of angina or ischemic changes on electrocardiogram. Significant liver disease as defined by transaminase levels or by history of cirrhosis or ascites. Significant renal disease defined by serum creatinine. Concurrent Medication: Excluded: Experimental drugs including fluconazole, and foscarnet. Immunomodulators including interferon, interleukins, or systemic corticosteroids. Ganciclovir. Neurotoxic drugs. Drugs that could potentially cause peripheral neuropathy, including chloramphenicol, cisplatin, iodoquinol, dapsone, phenytoin, disulfiram, ethionamide, glutethimide, gold, hydralazine, isoniazid, metronidazole, vincristine, and nitrofurantoin. Excluded within 4 weeks of study entry: Drugs that have caused significant nephrotoxicity or significant hepatotoxicity (as defined by transaminases). Concurrent Treatment: Excluded: Transfusion dependent. Patients are excluded if unwilling or unable to sign informed consent. Prior Medication: Excluded: Zidovudine (AZT). Dideoxycytidine (ddC). Any other nucleoside antiretrovirals. Positive antibody to HIV using any federally licensed ELISA test kit. Diagnosis of AIDS or AIDS-related complex (ARC). Active substance or alcohol abuse.
Facility Information:
Facility Name
Univ of California / San Diego Treatment Ctr
City
San Diego
State/Province
California
ZIP/Postal Code
921036325
Country
United States
Facility Name
Univ of Miami School of Medicine
City
Miami
State/Province
Florida
ZIP/Postal Code
331361013
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
1345755
Citation
Meng TC, Fischl MA, Boota AM, Spector SA, Bennett D, Bassiakos Y, Lai SH, Wright B, Richman DD. Combination therapy with zidovudine and dideoxycytidine in patients with advanced human immunodeficiency virus infection. A phase I/II study. Ann Intern Med. 1992 Jan 1;116(1):13-20. doi: 10.7326/0003-4819-116-1-13.
Results Reference
background
Citation
Meng TC, Boota A, Fischl MA, Spector SA, McCaan M, Richman DD. ACTG 106: Phase I/II dose finding study of concurrently administered dideoxycytidine (ddC) and zidovudine (ZDV, AZT). Int Conf AIDS. 1990 Jun 20-23;6(3):192 (abstract no SB426)
Results Reference
background
PubMed Identifier
2159707
Citation
Meng TC, Fischl MA, Richman DD. AIDS Clinical Trials Group: phase I/II study of combination 2',3'-dideoxycytidine and zidovudine in patients with acquired immunodeficiency syndrome (AIDS) and advanced AIDS-related complex. Am J Med. 1990 May 21;88(5B):27S-30S. doi: 10.1016/0002-9343(90)90419-e.
Results Reference
background
PubMed Identifier
9024175
Citation
Gries JM, Troconiz IF, Verotta D, Jacobson M, Sheiner LB. A pooled analysis of CD4 response to zidovudine and zalcitabine treatment in patients with AIDS and AIDS-related complex. Clin Pharmacol Ther. 1997 Jan;61(1):70-82. doi: 10.1016/S0009-9236(97)90183-1.
Results Reference
background

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A Study of Dideoxycytidine Plus Zidovudine in the Treatment of AIDS or Advanced AIDS Related Complex (ARC)

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