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A Phase II Study of Low-Dose Interleukin-2 by Subcutaneous Injection in Combination With Antiretroviral Therapy Versus Antiretroviral Therapy Alone in Patients With HIV-1 Infection and at Least 3 Months Stable Antiretroviral Therapy

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Aldesleukin
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 Interleukin-2, Drug Therapy, Combination, AIDS-Related Complex, Antiviral Agents

Eligibility Criteria

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

Inclusion Criteria Concurrent Medication: Allowed: PCP prophylaxis. Therapy for an opportunistic infection that develops on study, with the exception of foscarnet for CMV disease or resistant Herpes simplex. Systemic corticosteroids ONLY IF given for no longer than 21 days for acute PCP. Topical corticosteroids to areas separate from a skin test or IL-2 injection site. Acyclovir up to 1000 mg/day as maintenance for recurrent genital Herpes. Erythropoietin and filgrastim. Antiemetics. Antibiotics as clinically indicated. Elective standard immunizations at week 8 or later. Concurrent Treatment: Allowed: Local radiation therapy. Prior Medication: Required: Stable, approved antiretroviral therapy for at least 2 months (was 3 months, amended 3/26/96) prior to study entry. Patients must have: HIV seropositivity. CD4 count 300 - 700 cells/mm3. Stable antiretroviral therapy for at least 2 months (was 3 months, amended 3/26/96) prior to study entry. No history of AIDS-defining illness except for limited cutaneous Kaposi's sarcoma. Normal EKG (isolated nonspecific ST and T wave changes permitted). NOTE: This protocol is approved for prisoner participation. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Malignancy requiring systemic or local cytotoxic chemotherapy. Untreated thyroid disease. Asthma requiring intermittent or chronic inhalation or systemic therapy. Any medical condition that precludes study entry. Concurrent Medication: Excluded: Antianginal agents such as nitrates, calcium channel blockers, beta blockers, and antiarrhythmics. Systemic or local cytotoxic chemotherapy. Interferons. Interleukins other than study drug. Pentoxifylline ( Trental ). Acetylcysteine ( NAC ). Sargramostim ( GM-CSF ). Dinitrochlorobenzene ( DCNB ). Thymosin alpha 1. Thymopentin. Inosiplex ( Isoprinosine ). Polyribonucleoside ( Ampligen ). Ditiocarb sodium ( Imuthiol ). Therapeutic HIV vaccines. Investigational antiretroviral agents such as lamivudine ( 3TC ) and tat and protease inhibitors. Foscarnet. Aspirin. Immune globulin ( IVIG ). Thalidomide. Systemic corticosteroids (permitted for 21 days or less for PCP treatment only). Concurrent Treatment: Excluded: Ongoing transfusion. Patients with the following prior conditions are excluded: History of autoimmune disease, including inflammatory bowel disease and psoriasis (although autoimmune thyroid disease that is stable is allowed). Clinically significant CNS disease or seizures that have been active within 1 year prior to study entry. Prior Medication: Excluded: IL-2 within 3 months prior to study entry. Any immunomodulatory therapy within 4 weeks prior to study entry. Foscarnet within 4 weeks prior to study entry. Acute therapy for an opportunistic infection within 14 days prior to study entry. Active alcohol or substance abuse that would compromise study compliance.

Sites / Locations

  • Alabama Therapeutics CRS
  • University of Colorado Hospital CRS
  • Indiana Univ. School of Medicine, Infectious Disease Research Clinic
  • SUNY - Buffalo, Erie County Medical Ctr.
  • Beth Israel Med. Ctr. (Mt. Sinai)
  • NY Univ. HIV/AIDS CRS
  • Cornell University A2201
  • Unc Aids Crs
  • Case CRS
  • Hosp. of the Univ. of Pennsylvania 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)
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1. Study Identification

Unique Protocol Identification Number
NCT00000820
Brief Title
A Phase II Study of Low-Dose Interleukin-2 by Subcutaneous Injection in Combination With Antiretroviral Therapy Versus Antiretroviral Therapy Alone in Patients With HIV-1 Infection and at Least 3 Months Stable Antiretroviral Therapy
Official Title
A Phase II Study of Low-Dose Interleukin-2 by Subcutaneous Injection in Combination With Antiretroviral Therapy Versus Antiretroviral Therapy Alone in Patients With HIV-1 Infection and at Least 3 Months Stable Antiretroviral Therapy
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
March 2002 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

5. Study Description

Brief Summary
PRIMARY: To examine the effect of aldesleukin ( IL-2 ) on viral activity in the blood. To determine the safety of low-dose IL-2 in combination with antiretroviral therapy versus antiretroviral therapy alone. SECONDARY: To examine delayed type hypersensitivity responses to skin test antigens and antibody responses to protein and polysaccharide vaccines. The profound immune impairment that results from HIV-1 infection is due, at least in part, to the loss of CD4+ T cells and the cytokines these cells secrete, especially IL-2 and interferon-gamma. Antiretroviral agents do not directly address the problem of immune impairment. Replacement of IL-2 at nontoxic doses may prevent or delay clinical immunosuppression and its attendant opportunistic infections. Also, since patients with HIV-1 infection respond suboptimally to routine protein and polysaccharide immunizations, IL-2 may provide an adjuvant effect on vaccine responses.
Detailed Description
The profound immune impairment that results from HIV-1 infection is due, at least in part, to the loss of CD4+ T cells and the cytokines these cells secrete, especially IL-2 and interferon-gamma. Antiretroviral agents do not directly address the problem of immune impairment. Replacement of IL-2 at nontoxic doses may prevent or delay clinical immunosuppression and its attendant opportunistic infections. Also, since patients with HIV-1 infection respond suboptimally to routine protein and polysaccharide immunizations, IL-2 may provide an adjuvant effect on vaccine responses. Patients are randomized initially to receive their own antiretroviral therapy alone or in combination with IL-2 for 24 weeks, after which each group is crossed over to the other treatment assignment (i.e., IL-2 is either added or deleted from the regimen) for an additional 24 weeks. Patients who are vaccine eligible receive influenza, tetanus and diphtheria toxoid, and meningococcal polysaccharide vaccines at week 4, and those who have not received pneumococcal vaccine prior to study entry will receive it at week 8.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Interleukin-2, Drug Therapy, Combination, AIDS-Related Complex, Antiviral Agents

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Enrollment
104 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Aldesleukin

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed: PCP prophylaxis. Therapy for an opportunistic infection that develops on study, with the exception of foscarnet for CMV disease or resistant Herpes simplex. Systemic corticosteroids ONLY IF given for no longer than 21 days for acute PCP. Topical corticosteroids to areas separate from a skin test or IL-2 injection site. Acyclovir up to 1000 mg/day as maintenance for recurrent genital Herpes. Erythropoietin and filgrastim. Antiemetics. Antibiotics as clinically indicated. Elective standard immunizations at week 8 or later. Concurrent Treatment: Allowed: Local radiation therapy. Prior Medication: Required: Stable, approved antiretroviral therapy for at least 2 months (was 3 months, amended 3/26/96) prior to study entry. Patients must have: HIV seropositivity. CD4 count 300 - 700 cells/mm3. Stable antiretroviral therapy for at least 2 months (was 3 months, amended 3/26/96) prior to study entry. No history of AIDS-defining illness except for limited cutaneous Kaposi's sarcoma. Normal EKG (isolated nonspecific ST and T wave changes permitted). NOTE: This protocol is approved for prisoner participation. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Malignancy requiring systemic or local cytotoxic chemotherapy. Untreated thyroid disease. Asthma requiring intermittent or chronic inhalation or systemic therapy. Any medical condition that precludes study entry. Concurrent Medication: Excluded: Antianginal agents such as nitrates, calcium channel blockers, beta blockers, and antiarrhythmics. Systemic or local cytotoxic chemotherapy. Interferons. Interleukins other than study drug. Pentoxifylline ( Trental ). Acetylcysteine ( NAC ). Sargramostim ( GM-CSF ). Dinitrochlorobenzene ( DCNB ). Thymosin alpha 1. Thymopentin. Inosiplex ( Isoprinosine ). Polyribonucleoside ( Ampligen ). Ditiocarb sodium ( Imuthiol ). Therapeutic HIV vaccines. Investigational antiretroviral agents such as lamivudine ( 3TC ) and tat and protease inhibitors. Foscarnet. Aspirin. Immune globulin ( IVIG ). Thalidomide. Systemic corticosteroids (permitted for 21 days or less for PCP treatment only). Concurrent Treatment: Excluded: Ongoing transfusion. Patients with the following prior conditions are excluded: History of autoimmune disease, including inflammatory bowel disease and psoriasis (although autoimmune thyroid disease that is stable is allowed). Clinically significant CNS disease or seizures that have been active within 1 year prior to study entry. Prior Medication: Excluded: IL-2 within 3 months prior to study entry. Any immunomodulatory therapy within 4 weeks prior to study entry. Foscarnet within 4 weeks prior to study entry. Acute therapy for an opportunistic infection within 14 days prior to study entry. Active alcohol or substance abuse that would compromise study compliance.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Teppler H
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Pomerantz R
Official's Role
Study Chair
Facility Information:
Facility Name
Alabama Therapeutics CRS
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
University of Colorado Hospital CRS
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80262
Country
United States
Facility Name
Indiana Univ. School of Medicine, Infectious Disease Research Clinic
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
462025250
Country
United States
Facility Name
SUNY - Buffalo, Erie County Medical Ctr.
City
Buffalo
State/Province
New York
ZIP/Postal Code
14215
Country
United States
Facility Name
Beth Israel Med. Ctr. (Mt. Sinai)
City
New York
State/Province
New York
ZIP/Postal Code
10003
Country
United States
Facility Name
NY Univ. HIV/AIDS CRS
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Cornell University A2201
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Unc Aids Crs
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
275997215
Country
United States
Facility Name
Case CRS
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Hosp. of the Univ. of Pennsylvania CRS
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
15097300
Citation
Vogler MA, Teppler H, Gelman R, Valentine F, Lederman MM, Pomerantz RJ, Pollard RB, Cherng DW, Gonzalez CJ, Squires KE, Frank I, Mildvan D, Mahon LF, Schock B; AIDS Clinical Trials Group 248 Study Team. Daily low-dose subcutaneous interleukin-2 added to single- or dual-nucleoside therapy in HIV infection does not protect against CD4+ T-cell decline or improve other indices of immune function: results of a randomized controlled clinical trial (ACTG 248). J Acquir Immune Defic Syndr. 2004 May 1;36(1):576-87. doi: 10.1097/00126334-200405010-00005.
Results Reference
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A Phase II Study of Low-Dose Interleukin-2 by Subcutaneous Injection in Combination With Antiretroviral Therapy Versus Antiretroviral Therapy Alone in Patients With HIV-1 Infection and at Least 3 Months Stable Antiretroviral Therapy

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