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A Phase I Safety and Pharmacokinetics Study of 2',3'-Dideoxyinosine (ddI) Administered Twice Daily to Infants and Children With AIDS or Symptomatic HIV Infection

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Didanosine
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 Didanosine, Drug Evaluation, Acquired Immunodeficiency Syndrome, AIDS-Related Complex

Eligibility Criteria

3 Months - 12 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria Concurrent Medication: Allowed: Aerosolized pentamidine for Pneumocystis carinii pneumonia (PCP) prophylaxis if this drug is extended to children. Acute therapy not exceeding 7 days with oral or intravenous acyclovir for herpes simplex infections. Trimethoprim / sulfamethoxazole for Pneumocystis carinii infections during course of study at discretion of investigator after discussion with the sponsor. Symptomatic therapy with analgesics, antihistamines, antiemetics, antidiarrheal agents, or other supportive therapy as deemed necessary by the principal investigator. Patients must have: Diagnosis of AIDS as defined by CDC or meeting CDC P2 classification. Patients must be free of opportunistic infection or other serious bacterial, fungal, or parasitic infection at time of entry into study. Life expectancy > 6 months. Parent or guardian (and patient as applicable) able to give informed consent. Available for follow-up for at least 6 months. Allowed: Hemophilia. Exclusion Criteria Co-existing Condition: Children with the following are excluded: Chronic hematologic disorders unrelated to coagulation defects, hemoglobinopathies, or ITP. Intractable diarrhea. No venous access. History of seizures within previous 2 years or currently requiring anticonvulsants for control. Currently active heart disease as evidenced by a cardiac arrhythmia or other significant abnormality on routine electrocardiography (ECG) or shortening fraction of < 10 percent on echocardiogram. Renal disease. Any other clinical condition that in the opinion of the investigator makes the patient unsuitable for study. Concurrent Medication: Excluded: Antiretroviral drugs. Zidovudine (AZT). AL 721. Interferon. Corticosteroids. Immunomodulating drugs. Other systemic investigation agent. Ribavirin. Rifampin, barbiturates, or any other potent inducer or inhibitor of drug-metabolizing enzymes. Cytotoxic anticancer therapy. H-2 blockers. Intravenous ketoconazole. Immunoglobulin preparations. Children with the following are excluded: Chronic hematologic disorders unrelated to coagulation defects, hemoglobinopathies, or ITP. Intractable diarrhea. No venous access. History of seizures within previous 2 years or currently requiring anticonvulsants for control. Currently active heart disease as evidenced by a cardiac arrhythmia or other significant abnormality on routine electrocardiography (ECG) or shortening fraction of < 10 percent on echocardiogram. Renal disease. Any other clinical condition that in the opinion of the investigator makes the patient unsuitable for study. Renal disease. Prior Medication: Excluded: Any prior therapy which in the opinion of the investigator would make the patient unsuitable for study. Excluded within 2 weeks of study entry: Trimethoprim / sulfamethoxazole. Excluded within 1 month of study entry: Study drug or other antiretroviral drug or systemic investigational agent. Any agent known as a potent inducer or inhibitor of drug metabolizing enzymes. H-2 blockers. Ketoconazole. Immunoglobulin preparations. Excluded within 3 months of study entry: Ribavirin. Excluded: Zidovudine (AZT) for > 6 months. Cytotoxic anticancer therapy. Prior Treatment: Excluded within 4 weeks of study entry: Blood transfusion. Lymphocyte transfusions for immune reconstitution. Bone marrow transplant.

Sites / Locations

  • Univ of Alabama at Birmingham
  • Univ of Miami School of Medicine
  • The Regional Medical Ctr, Memphis
  • Baylor College of Medicine
  • Univ TX Health Science Ctr

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
August 25, 2008
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Bristol-Myers Squibb
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1. Study Identification

Unique Protocol Identification Number
NCT00000669
Brief Title
A Phase I Safety and Pharmacokinetics Study of 2',3'-Dideoxyinosine (ddI) Administered Twice Daily to Infants and Children With AIDS or Symptomatic HIV Infection
Official Title
A Phase I Safety and Pharmacokinetics Study of 2',3'-Dideoxyinosine (ddI) Administered Twice Daily to Infants and Children With AIDS or Symptomatic HIV Infection
Study Type
Interventional

2. Study Status

Record Verification Date
October 1996
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
Bristol-Myers Squibb

4. Oversight

5. Study Description

Brief Summary
To determine the safety and maximum tolerated dose (MTD) of 2',3'-dideoxyinosine (ddI), given orally and intravenously, in infants and children with AIDS. The study also measures bloodstream and cerebrospinal fluid (CSF) levels of the administered drug, and provides a preliminary assessment of the effectiveness of ddI on HIV replication. AMENDED: Based on safety established in the first dosing phase of 52 weeks and long term dosing data in adults, the dosing period will be extended to 104 weeks. Original design: Information presently available indicates that ddI has high antiviral activity with less apparent toxicity than zidovudine (AZT) (the drug presently used to treat AIDS).
Detailed Description
AMENDED: Based on safety established in the first dosing phase of 52 weeks and long term dosing data in adults, the dosing period will be extended to 104 weeks. Original design: Information presently available indicates that ddI has high antiviral activity with less apparent toxicity than zidovudine (AZT) (the drug presently used to treat AIDS). AMENDED: Dosing will proceed for 104 weeks at each dose level. Original design: Five patients are treated at the initial dose level. Because ddI is not stable in the acid environment of the stomach, oral doses of ddI follow administration of an antacid. An alternative method of dosing is to mix the reconstituted ddI with an appropriate volume of Maalox TC or Mylanta II. In order to determine the MTD, successive groups of 5 patients enter the study at a higher dose level after 3 patients have experienced 3 weeks of dosing and significant toxicities have not developed. Patients are assigned to treatment groups in the order in which they are enrolled. Dosing proceeds for 16 weeks at each dose level. However, consideration is given to escalating patients entered at the lowest dose to the next dose level after 10 weeks of dosing. The dose escalation continues until toxicities requiring dose modifications are found in 2 of 5 in any group.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Didanosine

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Months
Maximum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed: Aerosolized pentamidine for Pneumocystis carinii pneumonia (PCP) prophylaxis if this drug is extended to children. Acute therapy not exceeding 7 days with oral or intravenous acyclovir for herpes simplex infections. Trimethoprim / sulfamethoxazole for Pneumocystis carinii infections during course of study at discretion of investigator after discussion with the sponsor. Symptomatic therapy with analgesics, antihistamines, antiemetics, antidiarrheal agents, or other supportive therapy as deemed necessary by the principal investigator. Patients must have: Diagnosis of AIDS as defined by CDC or meeting CDC P2 classification. Patients must be free of opportunistic infection or other serious bacterial, fungal, or parasitic infection at time of entry into study. Life expectancy > 6 months. Parent or guardian (and patient as applicable) able to give informed consent. Available for follow-up for at least 6 months. Allowed: Hemophilia. Exclusion Criteria Co-existing Condition: Children with the following are excluded: Chronic hematologic disorders unrelated to coagulation defects, hemoglobinopathies, or ITP. Intractable diarrhea. No venous access. History of seizures within previous 2 years or currently requiring anticonvulsants for control. Currently active heart disease as evidenced by a cardiac arrhythmia or other significant abnormality on routine electrocardiography (ECG) or shortening fraction of < 10 percent on echocardiogram. Renal disease. Any other clinical condition that in the opinion of the investigator makes the patient unsuitable for study. Concurrent Medication: Excluded: Antiretroviral drugs. Zidovudine (AZT). AL 721. Interferon. Corticosteroids. Immunomodulating drugs. Other systemic investigation agent. Ribavirin. Rifampin, barbiturates, or any other potent inducer or inhibitor of drug-metabolizing enzymes. Cytotoxic anticancer therapy. H-2 blockers. Intravenous ketoconazole. Immunoglobulin preparations. Children with the following are excluded: Chronic hematologic disorders unrelated to coagulation defects, hemoglobinopathies, or ITP. Intractable diarrhea. No venous access. History of seizures within previous 2 years or currently requiring anticonvulsants for control. Currently active heart disease as evidenced by a cardiac arrhythmia or other significant abnormality on routine electrocardiography (ECG) or shortening fraction of < 10 percent on echocardiogram. Renal disease. Any other clinical condition that in the opinion of the investigator makes the patient unsuitable for study. Renal disease. Prior Medication: Excluded: Any prior therapy which in the opinion of the investigator would make the patient unsuitable for study. Excluded within 2 weeks of study entry: Trimethoprim / sulfamethoxazole. Excluded within 1 month of study entry: Study drug or other antiretroviral drug or systemic investigational agent. Any agent known as a potent inducer or inhibitor of drug metabolizing enzymes. H-2 blockers. Ketoconazole. Immunoglobulin preparations. Excluded within 3 months of study entry: Ribavirin. Excluded: Zidovudine (AZT) for > 6 months. Cytotoxic anticancer therapy. Prior Treatment: Excluded within 4 weeks of study entry: Blood transfusion. Lymphocyte transfusions for immune reconstitution. Bone marrow transplant.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Scott GB
Official's Role
Study Chair
Facility Information:
Facility Name
Univ of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Univ of Miami School of Medicine
City
Miami
State/Province
Florida
ZIP/Postal Code
331361013
Country
United States
Facility Name
The Regional Medical Ctr, Memphis
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38105
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Univ TX Health Science Ctr
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
1670591
Citation
Butler KM, Husson RN, Balis FM, Brouwers P, Eddy J, el-Amin D, Gress J, Hawkins M, Jarosinski P, Moss H, et al. Dideoxyinosine in children with symptomatic human immunodeficiency virus infection. N Engl J Med. 1991 Jan 17;324(3):137-44. doi: 10.1056/NEJM199101173240301.
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A Phase I Safety and Pharmacokinetics Study of 2',3'-Dideoxyinosine (ddI) Administered Twice Daily to Infants and Children With AIDS or Symptomatic HIV Infection

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