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An Open-Label, Staggered Rising Dose Cohort Study Assessing the Pharmacokinetics, Safety, and Tolerance of BI-RG-587 in Combination With Zidovudine in Patients With HIV Infection (CD4+ Cell Count < 400/mm3)

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Nevirapine
Zidovudine
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Drug Therapy, Combination, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Zidovudine, Nevirapine

Eligibility Criteria

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

Inclusion Criteria Concurrent Medication: Included: Pneumocystis carinii pneumonia prophylaxis (other than sulfamethoxazole alone or in combination with other medications). Antifungal prophylaxis with oral fluconazole or ketoconazole. Antiviral prophylaxis with a maximum of 1 g/day oral acyclovir. Patients must have the following: HIV infection. Ability to voluntarily provide written informed consent prior to treatment. Willing and able to follow protocol requirements. Patients with nonvisceral Kaposi's sarcoma or with visceral Kaposi's sarcoma not requiring chemotherapy and/or irradiation may be included. Exclusion Criteria Co-existing Condition: Patients with the following conditions or symptoms are excluded: Radiographic evidence of chronic pulmonary disease. Cytomegalovirus disease. Toxoplasmosis encephalitis requiring suppressive therapy. Mycobacteriosis requiring maintenance chemotherapy. Visceral Kaposi's sarcoma requiring chemotherapy and/or irradiation. Concurrent Medication: Excluded: Glucocorticoids and steroid hormones (including oral contraceptives). Dicumarol, warfarin, and other anticoagulant medications. Nitroglycerin. Digitoxin. Valproic acid. Tolbutamide. Doxycycline. Chloramphenicol. Isoniazid. Antiepileptics (Phenobarbital and other barbiturates). Sulfonamides. Excluded for up to 4 hours before and 4 hours after administration of drug 2: Antacids. Cimetidine. Carafate. Cholestyramine resin. Alcohol and alcohol-containing substances. Benzodiazepines (diazepam, triazolam). Patients with the following are excluded: History of clinically important disease (defined as a disease that, in the opinion of the investigator, may either put the patient at risk because of participation in the study or a disease that may influence the results of the study or the patient's ability to participate in the study) other than HIV infection. Malignancy other than Kaposi's sarcoma or limited cutaneous basal cell carcinoma. Prior Medication: Excluded within 4 weeks prior to administration of study drug 2: Antiretroviral (other than zidovudine (AZT)), immunosuppressive, or cytotoxic drugs. Glucocorticoids and steroid hormones (including oral contraceptives). Dicumarol, warfarin, and other anticoagulant medications. Nitroglycerin. Digitoxin. Valproic acid. Tolbutamide. Doxycycline. Chloramphenicol Isoniazid. Antiepileptics (Phenobarbital and other barbiturates). Sulfonamides.

Sites / Locations

  • Cooper Green Hosp
  • Univ of California / San Diego Treatment Ctr
  • Univ of Massachusetts

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
July 29, 2008
Sponsor
Boehringer Ingelheim
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1. Study Identification

Unique Protocol Identification Number
NCT00000649
Brief Title
An Open-Label, Staggered Rising Dose Cohort Study Assessing the Pharmacokinetics, Safety, and Tolerance of BI-RG-587 in Combination With Zidovudine in Patients With HIV Infection (CD4+ Cell Count < 400/mm3)
Official Title
An Open-Label, Staggered Rising Dose Cohort Study Assessing the Pharmacokinetics, Safety, and Tolerance of BI-RG-587 in Combination With Zidovudine in Patients With HIV Infection (CD4+ Cell Count < 400/mm3)
Study Type
Interventional

2. Study Status

Record Verification Date
June 1993
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
Boehringer Ingelheim

4. Oversight

5. Study Description

Brief Summary
To assess the safety and tolerance of multiple oral doses of nevirapine in combination with zidovudine (AZT); to get information on the pharmacokinetics (blood levels) and dose proportionality of nevirapine/AZT with multiple dosing; to characterize the pattern of virological activity in vivo (in humans) of nevirapine in combination with AZT; to determine whether development of resistance to either drug is slowed by the use of the combination. Drugs now used in treatment for patients with AIDS show some toxicity which limits their usefulness. In addition, with long-term treatment with AZT, there is evidence of virus resistance to the drug. Compounds that are more effective and less toxic than those in present use would be beneficial, especially if they are active against AZT-resistant viruses. Nevirapine has shown in vitro (test tube studies) activity in inhibiting HIV replication (reproduction). In vitro studies have shown that nevirapine and AZT work together to inhibit HIV replication.
Detailed Description
Drugs now used in treatment for patients with AIDS show some toxicity which limits their usefulness. In addition, with long-term treatment with AZT, there is evidence of virus resistance to the drug. Compounds that are more effective and less toxic than those in present use would be beneficial, especially if they are active against AZT-resistant viruses. Nevirapine has shown in vitro (test tube studies) activity in inhibiting HIV replication (reproduction). In vitro studies have shown that nevirapine and AZT work together to inhibit HIV replication. Groups of 10 patients are studied at each of three dose levels. Five patients at each dose level have less than 3 months of prior AZT treatment; five patients at each dose level have at least 12 months of previous AZT treatment and tolerated an AZT regimen of 600 mg/day (200 mg every 8 hours). At least 24 patient-weeks of treatment with the combination treatment must be completed without requiring dose interruption before the next dosage level can be started. All 30 patients must be enrolled at a lower dosage level before a higher dosage level is started. Patients begin treatment with AZT. 14 days later, patients begin treatment with nevirapine in addition to the AZT. After 24 weeks, patients have the option to continue long-term treatment with either nevirapine or standard treatment.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

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

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Included: Pneumocystis carinii pneumonia prophylaxis (other than sulfamethoxazole alone or in combination with other medications). Antifungal prophylaxis with oral fluconazole or ketoconazole. Antiviral prophylaxis with a maximum of 1 g/day oral acyclovir. Patients must have the following: HIV infection. Ability to voluntarily provide written informed consent prior to treatment. Willing and able to follow protocol requirements. Patients with nonvisceral Kaposi's sarcoma or with visceral Kaposi's sarcoma not requiring chemotherapy and/or irradiation may be included. Exclusion Criteria Co-existing Condition: Patients with the following conditions or symptoms are excluded: Radiographic evidence of chronic pulmonary disease. Cytomegalovirus disease. Toxoplasmosis encephalitis requiring suppressive therapy. Mycobacteriosis requiring maintenance chemotherapy. Visceral Kaposi's sarcoma requiring chemotherapy and/or irradiation. Concurrent Medication: Excluded: Glucocorticoids and steroid hormones (including oral contraceptives). Dicumarol, warfarin, and other anticoagulant medications. Nitroglycerin. Digitoxin. Valproic acid. Tolbutamide. Doxycycline. Chloramphenicol. Isoniazid. Antiepileptics (Phenobarbital and other barbiturates). Sulfonamides. Excluded for up to 4 hours before and 4 hours after administration of drug 2: Antacids. Cimetidine. Carafate. Cholestyramine resin. Alcohol and alcohol-containing substances. Benzodiazepines (diazepam, triazolam). Patients with the following are excluded: History of clinically important disease (defined as a disease that, in the opinion of the investigator, may either put the patient at risk because of participation in the study or a disease that may influence the results of the study or the patient's ability to participate in the study) other than HIV infection. Malignancy other than Kaposi's sarcoma or limited cutaneous basal cell carcinoma. Prior Medication: Excluded within 4 weeks prior to administration of study drug 2: Antiretroviral (other than zidovudine (AZT)), immunosuppressive, or cytotoxic drugs. Glucocorticoids and steroid hormones (including oral contraceptives). Dicumarol, warfarin, and other anticoagulant medications. Nitroglycerin. Digitoxin. Valproic acid. Tolbutamide. Doxycycline. Chloramphenicol Isoniazid. Antiepileptics (Phenobarbital and other barbiturates). Sulfonamides.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sarah Cheeseman
Official's Role
Study Chair
Facility Information:
Facility Name
Cooper Green Hosp
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
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 Massachusetts
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Cheeseman SH. Nevirapine (NVP) alone and in combination with zidovudine (ZDV): safety and activity. The ACTG 164/168 Study Team. Int Conf AIDS. 1992 Jul 19-24;8(1):Mo15 (abstract no MoB 0053)
Results Reference
background
PubMed Identifier
7530585
Citation
Cheeseman SH, Havlir D, McLaughlin MM, Greenough TC, Sullivan JL, Hall D, Hattox SE, Spector SA, Stein DS, Myers M, et al. Phase I/II evaluation of nevirapine alone and in combination with zidovudine for infection with human immunodeficiency virus. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Feb 1;8(2):141-51.
Results Reference
background
Citation
Murphy RL, Montaner J. Nevirapine: A review of its development, pharmacological profile and potential for clinical use. Exp Opin Invest Drugs. 1996;5(9): 1183-1199
Results Reference
background
Citation
Havlir D. Antiviral activity of nevirapine at 400 mg in p24 antigen positive adults. ACTG 164 and 168 Study Teams. Int Conf AIDS. 1993 Jun 6-11;9(1):69 (abstract no WS-B26-1)
Results Reference
background
Citation
Greenough TC. Quantitative virology: the experience during the nevirapine phase I/II trials. ACTG 164/168 Study Team. Int Conf AIDS. 1992 Jul 19-24;8(2):B192 (abstract no PoB 3610)
Results Reference
background
Citation
Cheeseman SH, Murphy RL, Saag MS, Havlir D. Safety of high dose nevirapine (NVP) after 200 mg/d lead-in. ACTG 164/168 Study Team. Int Conf AIDS. 1993 Jun 6-11;9(1):487 (abstract no PO-B26-2109)
Results Reference
background
Citation
Hattox S. Pharmacokinetics of nevirapine alone and in combination with zidovudine. The ACTG 164/168 Study Team. Int Conf AIDS. 1992 Jul 19-24;8(2):B185 (abstract no PoB 3591)
Results Reference
background
Citation
Richman DD. Loss of nevirapine activity associated with the emergence of resistance in clinical trials. The ACTG 164/168 Study Team. Int Conf AIDS. 1992 Jul 19-24;8(2):B183 (abstract no PoB 3576)
Results Reference
background

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An Open-Label, Staggered Rising Dose Cohort Study Assessing the Pharmacokinetics, Safety, and Tolerance of BI-RG-587 in Combination With Zidovudine in Patients With HIV Infection (CD4+ Cell Count < 400/mm3)

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