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Granulocyte-Macrophage Colony-Stimulating Factor and Zidovudine: A Phase I Study of Concurrent Administration in Patients With AIDS and Severe ARC

Primary Purpose

HIV Infections, Cytopenias

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Zidovudine
Sargramostim
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 Neutropenia, Drug Evaluation, Drug Therapy, Combination, Granulocyte-Macrophage Colony-Stimulating Factor, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Zidovudine

Eligibility Criteria

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

Inclusion Criteria Concurrent Medication: Allowed: Modest doses of acetaminophen, aspirin, or non-prescription doses of ibuprofen may be used with caution for fever control and mild analgesia. Prolonged use more than 72 hours is not advised without dose supervision. All patients should have a documented history of positive HIV antibody by ELISA test. Patients should qualify for zidovudine (AZT) treatment for the following reasons: Patients with a prior episode of cytologically confirmed Pneumocystis carinii pneumonia (PCP). Patients with a prior episode of any AIDS-defining opportunistic infection and less than 200 T4 cells. Patients with advanced ARC as defined by mucocutaneous candidiasis and/or unexplained weight loss and less than 200 T4 cells and fever more than 100 degrees F of more than 3 weeks duration; clinical diagnosis of hairy leukoplakia; herpes zoster infection within 3 months of entry; or unexplained diarrhea. All patients must have received at least 8 weeks of AZT prior to enrollment and must not have required a dose adjustment for the previous 4 weeks. Patients must be willing to sign an informed consent statement. Required: Zidovudine (AZT) for at least 8 weeks. Exclusion Criteria Co-existing Condition: The following patients will be excluded: Patients receiving zidovudine (AZT) while enrolled in another protocol. Patients with other life-threatening and uncontrolled opportunistic infection. Patients with evidence of lymphoma or neoplasm other than indolent Kaposi's sarcoma. Dementia that would prevent giving appropriate informed consent. Concurrent Medication: Excluded: Acetaminophen or products containing acetaminophen. Drugs that are nephrotoxic, are cytotoxic, or decrease blood cell number or function may increase the risk of toxicity. Probenecid may inhibit excretion of zidovudine (AZT). Some experimental nucleoside analogs should be avoided. The following patients will be excluded: Patients receiving zidovudine (AZT) while enrolled in another protocol. Patients with other life-threatening and uncontrolled opportunistic infection. Patients with evidence of lymphoma or neoplasm other than indolent Kaposi's sarcoma. Dementia that would prevent giving appropriate informed consent. Prior Medication: Excluded within 8 weeks of study entry: Prior systemic therapy with an antimetabolite, cytotoxic drug, interferon, immunomodulator, corticosteroid, or nucleoside analog other than zidovudine.

Sites / Locations

  • SUNY / Erie County Med Ctr at Buffalo

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
NCT00000711
Brief Title
Granulocyte-Macrophage Colony-Stimulating Factor and Zidovudine: A Phase I Study of Concurrent Administration in Patients With AIDS and Severe ARC
Official Title
Granulocyte-Macrophage Colony-Stimulating Factor and Zidovudine: A Phase I Study of Concurrent Administration in Patients With AIDS and Severe ARC
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
May 1990 (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
To administer colony-stimulating factor (GM-CSF) for 4 weeks to AIDS and advanced AIDS related complex (ARC) patients who have been receiving zidovudine (AZT) therapy, in order to obtain data on short-term effectiveness, safety, toxicity, pharmacokinetics, and tolerance of combined treatment with the two drugs. Persons infected with HIV virus may undergo a long latency or persistent virus blood levels which may be present before any symptomatic illness. These individuals could, therefore, benefit from therapy with an effective antiretroviral agent. AZT, which is a powerful inhibitor of human retrovirus, has been approved for management of patients with symptomatic HIV infection. GM-CSF not only stimulates the bone marrow, it enhances the function of mature blood cells and has been found to enhance the ability of AZT to suppress HIV replication in vitro (test tube). Combination therapy with GM-CSF and AZT may lower complications as well as the morbidity and mortality associated with HIV infection.
Detailed Description
Persons infected with HIV virus may undergo a long latency or persistent virus blood levels which may be present before any symptomatic illness. These individuals could, therefore, benefit from therapy with an effective antiretroviral agent. AZT, which is a powerful inhibitor of human retrovirus, has been approved for management of patients with symptomatic HIV infection. GM-CSF not only stimulates the bone marrow, it enhances the function of mature blood cells and has been found to enhance the ability of AZT to suppress HIV replication in vitro (test tube). Combination therapy with GM-CSF and AZT may lower complications as well as the morbidity and mortality associated with HIV infection. Colony stimulating factor (GM-CSF) is administered subcutaneously, once a day or every other day, for 4 weeks to AIDS and advanced ARC patients who have been receiving and will continue to receive a constant dose of AZT. Treatment is on an outpatient basis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections, Cytopenias
Keywords
Neutropenia, Drug Evaluation, Drug Therapy, Combination, Granulocyte-Macrophage Colony-Stimulating Factor, Acquired Immunodeficiency Syndrome, AIDS-Related Complex, Zidovudine

7. Study Design

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

8. Arms, Groups, and Interventions

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

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed: Modest doses of acetaminophen, aspirin, or non-prescription doses of ibuprofen may be used with caution for fever control and mild analgesia. Prolonged use more than 72 hours is not advised without dose supervision. All patients should have a documented history of positive HIV antibody by ELISA test. Patients should qualify for zidovudine (AZT) treatment for the following reasons: Patients with a prior episode of cytologically confirmed Pneumocystis carinii pneumonia (PCP). Patients with a prior episode of any AIDS-defining opportunistic infection and less than 200 T4 cells. Patients with advanced ARC as defined by mucocutaneous candidiasis and/or unexplained weight loss and less than 200 T4 cells and fever more than 100 degrees F of more than 3 weeks duration; clinical diagnosis of hairy leukoplakia; herpes zoster infection within 3 months of entry; or unexplained diarrhea. All patients must have received at least 8 weeks of AZT prior to enrollment and must not have required a dose adjustment for the previous 4 weeks. Patients must be willing to sign an informed consent statement. Required: Zidovudine (AZT) for at least 8 weeks. Exclusion Criteria Co-existing Condition: The following patients will be excluded: Patients receiving zidovudine (AZT) while enrolled in another protocol. Patients with other life-threatening and uncontrolled opportunistic infection. Patients with evidence of lymphoma or neoplasm other than indolent Kaposi's sarcoma. Dementia that would prevent giving appropriate informed consent. Concurrent Medication: Excluded: Acetaminophen or products containing acetaminophen. Drugs that are nephrotoxic, are cytotoxic, or decrease blood cell number or function may increase the risk of toxicity. Probenecid may inhibit excretion of zidovudine (AZT). Some experimental nucleoside analogs should be avoided. The following patients will be excluded: Patients receiving zidovudine (AZT) while enrolled in another protocol. Patients with other life-threatening and uncontrolled opportunistic infection. Patients with evidence of lymphoma or neoplasm other than indolent Kaposi's sarcoma. Dementia that would prevent giving appropriate informed consent. Prior Medication: Excluded within 8 weeks of study entry: Prior systemic therapy with an antimetabolite, cytotoxic drug, interferon, immunomodulator, corticosteroid, or nucleoside analog other than zidovudine.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hewitt RG
Official's Role
Study Chair
Facility Information:
Facility Name
SUNY / Erie County Med Ctr at Buffalo
City
Buffalo
State/Province
New York
ZIP/Postal Code
14215
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Portmore A, Morse G, Hewitt R, Reichman R. Comparative oral disposition of zidovudine in neutropenic AIDS patients and asymptomatic hemophiliacs. Int Conf AIDS. 1990 Jun 20-23;6(3):196 (abstract no SB442)
Results Reference
background
PubMed Identifier
8460920
Citation
Hewitt RG, Morse GD, Lawrence WD, Maliszewski ML, Santora J, Bartos L, Bonnem E, Poiesz B. Pharmacokinetics and pharmacodynamics of granulocyte-macrophage colony-stimulating factor and zidovudine in patients with AIDS and severe AIDS-related complex. Antimicrob Agents Chemother. 1993 Mar;37(3):512-22. doi: 10.1128/AAC.37.3.512.
Results Reference
background
PubMed Identifier
29535451
Citation
Wang GJ, Zhao J, Tomasi D, Kojori ES, Wang R, Wiers CE, Caparelli EC, Volkow ND. Effect of combined naltrexone and bupropion therapy on the brain's functional connectivity. Int J Obes (Lond). 2018 Nov;42(11):1890-1899. doi: 10.1038/s41366-018-0040-2. Epub 2018 Feb 23.
Results Reference
derived

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Granulocyte-Macrophage Colony-Stimulating Factor and Zidovudine: A Phase I Study of Concurrent Administration in Patients With AIDS and Severe ARC

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