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Cidofovir Instillation in Hematopoietic Stem Cell Transplant (HSCT) Recipients With Hemorrhagic Cystitis

Primary Purpose

Cystitis, Bladder Diseases

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Cidofovir
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cystitis focused on measuring Cidofovir, Vistide, Adenovirus, BK virus infections, HSCT, Hemorrhagic Cystitis, Foley catheter, Viral infection, Bladder instillation, Intravesical, Transurethral catheter, Transplantation

Eligibility Criteria

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

Inclusion Criteria:

  1. Polyoma BK or adenovirus viruria has been established either by positive urine cytology or by PCR for BK virus or by positive urine and/or blood culture for adenovirus
  2. The patient has either gross hematuria and/or passes blood clots
  3. Signed informed consent form
  4. Hospitalized patients with a Foley catheter
  5. Women of childbearing potential must agree to use 2 acceptable methods of birth control (e. g., abstinence, IUD, or barrier method), during the study period and one for a period of 2 months afterward. At least one of the methods must be a barrier method. Males must also agree to use acceptable method of birth control (barrier method) during the study period and for 2 months afterward.

Exclusion Criteria:

  1. Serum creatinine >1.5 mg/dl and/or calculated creatinine clearance < 55 ml/min using the Cockcroft-Gault Creatinine Clearance formula (CrCl). CrCl = {(140-Age) x Weight (kgs) x 0.85 (if female)}/ {72x Serum Creatinine (mg/dl)}
  2. Urine protein > 100 mg/dl (equivalent to > 2+ proteinuria)
  3. Age less than 18 years
  4. Prior therapy with formalin or carboprost 1 mg % administered intravesically
  5. Hypersensitivity to cidofovir, probenecid or sulfa-containing medications
  6. Have received prior cidofovir therapy within 2 weeks.
  7. Prior enrollment in the study
  8. Women who are pregnant or breast-feeding
  9. Evidence of end-organ adenoviral infection

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Cidofovir

    Arm Description

    Outcomes

    Primary Outcome Measures

    Systemic Absorption of Cidofovir via bladder instillation

    Secondary Outcome Measures

    Full Information

    First Posted
    August 7, 2009
    Last Updated
    May 13, 2019
    Sponsor
    M.D. Anderson Cancer Center
    Collaborators
    Gilead Sciences
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00956176
    Brief Title
    Cidofovir Instillation in Hematopoietic Stem Cell Transplant (HSCT) Recipients With Hemorrhagic Cystitis
    Official Title
    Intravesical Cidofovir Instillation in HSCT Recipients With Hemorrhagic Cystitis: A Single Dose Pharmacokinetic Study
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2019
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    undefined (undefined)
    Primary Completion Date
    undefined (undefined)
    Study Completion Date
    undefined (undefined)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    M.D. Anderson Cancer Center
    Collaborators
    Gilead Sciences

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The goal of this clinical research study is to learn how the body absorbs and processes 1 dose of cidofovir that is given directly into the bladder, in patients with a viral infection that is causing bleeding from the bladder. The safety of this drug dose and the investigational way it is given (directly into the bladder) will also be studied.
    Detailed Description
    The Study Drug: Cidofovir is designed to fight CMV (a viral infection) by blocking the CMV cells from dividing. Cidofovir is commonly given by injection. For research purposes, in this study it will be given directly into the bladder through a foley catheter. This is one of the first studies where cidofovir is being given this way in humans. Study Drug Administration: If you are found to be eligible to take part in this study, on Day 1, Cidofovir will be put into your bladder through your foley catheter. The catheter will be clamped for 2 hours to keep the drug in your bladder. After 2 hours, the catheter will be unclamped. If you were receiving bladder irrigation as therapy for your hemorrhagic cystitis, this will be restarted. Study Tests on Day 1: On the day you receive cidofovir, blood (about 2 teaspoons) will be drawn 6 times. The first blood draw will occur before the cidofovir dose, and the last blood draw will occur 24 hours (+/- 1 hour) after the start of the dose. This blood will be used for pharmacokinetic (PK) and pharmacodynamic (PD) testing. PK testing measures the amount of study drug in the body at different time points. PD testing is used to look at how the level of study drug in your body may affect the disease. Viral Load Testing: During this study, extra urine and leftover blood to be collected and used for research to test for certain viruses. These viruses include the type of infection you had when joining this study, as well as cytomegalovirus (CMV) and another type of herpes virus. The urine samples will be collected before the cidofovir dose on Day 1, after the cidofovir dose on Day 1, and again on Day 4. Any blood left over from Day 1 testing will also be used for viral load testing. It is possible that these urine and/or blood samples will be sent to an outside lab to perform this testing. If that occurs, your name and any personal identifying information will be coded before the samples are sent. Coding the samples is designed to protect your privacy. Follow-Up Tests: Blood (about 2 teaspoons) will be drawn for routine tests 2 times during the week after your cidofovir dose. On Day 7 (+/- 2 days), you will be checked for any side effects that could be related to the study drug. In addition, on Day 14 (+/- 2 days), blood samples will be drawn for PK testing, urine will be collected for routine tests, and your safety data will be recorded. One final follow-up visit will take place on Day 30 (+/- 2 days). During this visit, the study staff will record any serious side effects you may be experiencing. Length of Study Participation: Your active study participation will be over after the Day 7 follow-up visit (+/- 2 days). If you experienced a side effect, however, the study staff will continue checking your medical records until the side effect becomes stable or gets better. This is an investigational study. Cidofovir given by injection is commercially available and FDA approved to treat CMV in patients with HIV. It is investigational to give cidofovir directly into the bladder of patients who have a viral infection causing bleeding in the bladder. Up to 6 patients will take part in this study. All will be enrolled at M. D. Anderson.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Cystitis, Bladder Diseases
    Keywords
    Cidofovir, Vistide, Adenovirus, BK virus infections, HSCT, Hemorrhagic Cystitis, Foley catheter, Viral infection, Bladder instillation, Intravesical, Transurethral catheter, Transplantation

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Cidofovir
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    Cidofovir
    Other Intervention Name(s)
    Vistide
    Intervention Description
    Single dose of 5 mg/kg administered in 100 ml of normal saline solution through a foley catheter to bladder. The catheter will be clamped for 2 hours to keep the drug in bladder.
    Primary Outcome Measure Information:
    Title
    Systemic Absorption of Cidofovir via bladder instillation
    Time Frame
    Blood collected pre-instillation, 1 hour, 2 hours, 4 hours and 14 hours after instillation.

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Polyoma BK or adenovirus viruria has been established either by positive urine cytology or by PCR for BK virus or by positive urine and/or blood culture for adenovirus The patient has either gross hematuria and/or passes blood clots Signed informed consent form Hospitalized patients with a Foley catheter Women of childbearing potential must agree to use 2 acceptable methods of birth control (e. g., abstinence, IUD, or barrier method), during the study period and one for a period of 2 months afterward. At least one of the methods must be a barrier method. Males must also agree to use acceptable method of birth control (barrier method) during the study period and for 2 months afterward. Exclusion Criteria: Serum creatinine >1.5 mg/dl and/or calculated creatinine clearance < 55 ml/min using the Cockcroft-Gault Creatinine Clearance formula (CrCl). CrCl = {(140-Age) x Weight (kgs) x 0.85 (if female)}/ {72x Serum Creatinine (mg/dl)} Urine protein > 100 mg/dl (equivalent to > 2+ proteinuria) Age less than 18 years Prior therapy with formalin or carboprost 1 mg % administered intravesically Hypersensitivity to cidofovir, probenecid or sulfa-containing medications Have received prior cidofovir therapy within 2 weeks. Prior enrollment in the study Women who are pregnant or breast-feeding Evidence of end-organ adenoviral infection
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Roy F. Chemaly, MD, MPH, MBA
    Organizational Affiliation
    UT MD Anderson Cancer Center
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Links:
    URL
    http://www.mdanderson.org
    Description
    UT MD Anderson Cancer Center

    Learn more about this trial

    Cidofovir Instillation in Hematopoietic Stem Cell Transplant (HSCT) Recipients With Hemorrhagic Cystitis

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