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A Study of Letrazuril in the Treatment of AIDS-Related Diarrhea

Primary Purpose

Cryptosporidiosis, HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Letrazuril
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 Cryptosporidiosis focused on measuring Cryptosporidiosis, Diarrhea, Acquired Immunodeficiency Syndrome, Antiprotozoal Agents, Triazines

Eligibility Criteria

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

Inclusion Criteria Concurrent Medication: Allowed: Anti-diarrheal and antiemetic medications. Anti-HIV agents such as zidovudine, ddI, and ddC if dosing regimens were stable for at least 3 weeks prior to start of study drug. Patients must have: AIDS. Chronic diarrhea with presence of Cryptosporidium oocysts in a stool specimen. CD4 count < 150/mm3 (not required if patient has had cryptosporidiosis for a minimum of 4 weeks). Life expectancy of at least 1 month. Prior Medication: Allowed: Anti-HIV agents such as zidovudine, ddI, and ddC if dosing regimens were stable for at least 3 weeks prior to start of study drug. Anti-diarrheal and antiemetic medications. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Grade 4 hematologic toxicity or grade 3 other toxicity ( patients with grade 3 hepatic toxicity may be enrolled if abnormalities are considered to be caused by biliary cryptosporidiosis). Presence of other diarrhea-causing pathogens. Active (defined as newly diagnosed, progressive, or requiring therapeutic intervention) opportunistic infection that requires antimicrobial therapy (patients receiving maintenance or prophylactic antimicrobial therapy for opportunistic infection may be enrolled if the dosing regimen has been stable for at least 3 weeks). Evidence of cytomegalovirus retinitis or colitis. Concurrent Medication: Excluded: Ganciclovir, cancer chemotherapy, or interferon-alpha or other immunomodulating agents. Any investigational drug (drugs available under an FDA-authorized expanded access program will not be considered investigational). Prior Medication: Excluded: Any investigational drug within 1 month prior to start of study drug (drugs available under an FDA-authorized expanded access program will not be considered investigational). Ganciclovir, cancer chemotherapy, or interferon-alpha or other immunomodulating agents within 7 days prior to start of study drug.

Sites / Locations

  • USC School of Medicine
  • Dr Douglas Dieterich
  • Cornell Univ Med Ctr
  • Saint Luke's - Roosevelt Hosp Ctr

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
June 23, 2005
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Janssen Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00001018
Brief Title
A Study of Letrazuril in the Treatment of AIDS-Related Diarrhea
Official Title
Blinded, Placebo-Controlled, Single-Dose Pharmacokinetics and Dose Escalation, Efficacy, and Safety Study of Letrazuril for AIDS-Related Cryptosporidial Diarrhea
Study Type
Interventional

2. Study Status

Record Verification Date
October 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
Janssen Pharmaceuticals

4. Oversight

5. Study Description

Brief Summary
To determine the pharmacokinetic profile of single doses of letrazuril in patients with AIDS-related cryptosporidial diarrhea; to determine the dose proportionality of single escalating doses of letrazuril; to determine steady-state concentrations of letrazuril; to evaluate the safety and efficacy of escalating doses of letrazuril, compared with placebo, for patients with AIDS-related cryptosporidial diarrhea. Letrazuril, the p-fluor analog of diclazuril, has been shown in an animal model to prevent infections by organisms closely related to the intracellular parasite Cryptosporidium. Reliable data are needed to show the effectiveness of letrazuril in treating AIDS-related cryptosporidial diarrhea.
Detailed Description
Letrazuril, the p-fluor analog of diclazuril, has been shown in an animal model to prevent infections by organisms closely related to the intracellular parasite Cryptosporidium. Reliable data are needed to show the effectiveness of letrazuril in treating AIDS-related cryptosporidial diarrhea. Four groups of eight patients receive escalating doses of oral letrazuril (or placebo). In each group, six patients are randomized to receive letrazuril and two patients receive matching placebo. In the pharmacokinetics determination phase of the study, patients receive a single dose of letrazuril or placebo following a meal. Following a 72-hour blood collection, patients enter the blinded, treatment phase of the study and receive letrazuril or placebo as a single dose daily, after a meal, for 3 weeks. Patients with persistent Cryptosporidium oocysts in their stools at the end of the blinded treatment phase may continue with open-label treatment of letrazuril at the same dose for 4 weeks; the dose may subsequently be escalated every 4 weeks, to a maximum, if oocysts persist. Patients who have Cryptosporidium oocysts eradicated from their stools will discontinue treatment and be followed for 3 months. All patients undergo clinical follow-up at 3 and 6 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cryptosporidiosis, HIV Infections
Keywords
Cryptosporidiosis, Diarrhea, Acquired Immunodeficiency Syndrome, Antiprotozoal Agents, Triazines

7. Study Design

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

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Letrazuril

10. Eligibility

Sex
All
Minimum Age & Unit of Time
13 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed: Anti-diarrheal and antiemetic medications. Anti-HIV agents such as zidovudine, ddI, and ddC if dosing regimens were stable for at least 3 weeks prior to start of study drug. Patients must have: AIDS. Chronic diarrhea with presence of Cryptosporidium oocysts in a stool specimen. CD4 count < 150/mm3 (not required if patient has had cryptosporidiosis for a minimum of 4 weeks). Life expectancy of at least 1 month. Prior Medication: Allowed: Anti-HIV agents such as zidovudine, ddI, and ddC if dosing regimens were stable for at least 3 weeks prior to start of study drug. Anti-diarrheal and antiemetic medications. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Grade 4 hematologic toxicity or grade 3 other toxicity ( patients with grade 3 hepatic toxicity may be enrolled if abnormalities are considered to be caused by biliary cryptosporidiosis). Presence of other diarrhea-causing pathogens. Active (defined as newly diagnosed, progressive, or requiring therapeutic intervention) opportunistic infection that requires antimicrobial therapy (patients receiving maintenance or prophylactic antimicrobial therapy for opportunistic infection may be enrolled if the dosing regimen has been stable for at least 3 weeks). Evidence of cytomegalovirus retinitis or colitis. Concurrent Medication: Excluded: Ganciclovir, cancer chemotherapy, or interferon-alpha or other immunomodulating agents. Any investigational drug (drugs available under an FDA-authorized expanded access program will not be considered investigational). Prior Medication: Excluded: Any investigational drug within 1 month prior to start of study drug (drugs available under an FDA-authorized expanded access program will not be considered investigational). Ganciclovir, cancer chemotherapy, or interferon-alpha or other immunomodulating agents within 7 days prior to start of study drug.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Moskovitz BL
Official's Role
Study Chair
Facility Information:
Facility Name
USC School of Medicine
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Dr Douglas Dieterich
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Cornell Univ Med Ctr
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Saint Luke's - Roosevelt Hosp Ctr
City
New York
State/Province
New York
ZIP/Postal Code
10025
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Guillem S, Gomez M, Romeu J, Raventos A, Fernandez A, Condom MJ, Clotet B. Letrazuril for the treatment of severe cryptosporidial diarrhoea in AIDS. Int Conf AIDS. 1992 Jul 19-24;8(2):B129 (abstract no PoB 3257)
Results Reference
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PubMed Identifier
7986407
Citation
Harris M, Deutsch G, MacLean JD, Tsoukas CM. A phase I study of letrazuril in AIDS-related cryptosporidiosis. AIDS. 1994 Aug;8(8):1109-13. doi: 10.1097/00002030-199408000-00011.
Results Reference
background
Citation
Rubbert A, Schwab J, Kalden JR, Nusslein H. Myositis, fever, rash and thrombopenia after letrazuril treatment of intestinal cryptosporidiosis: a case report. Int Conf AIDS. 1993 Jun 6-11;9(1):373 (abstract no PO-B10-1430)
Results Reference
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A Study of Letrazuril in the Treatment of AIDS-Related Diarrhea

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