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The Safety and Effectiveness of Hydroxyurea and ddI Used Individually or Together in HIV-Infected Patients

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Hydroxyurea
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 Therapy, Combination, Antiviral Agents, Hydroxyurea

Eligibility Criteria

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

Inclusion Criteria Concurrent Medication: Allowed: AS PER AMENDMENT 5/5/97: PCP prophylaxis with trimethoprim/sulfamethoxazole or Dapsone. Patients must have: HIV-1 infection. AS PER AMENDMENT 5/5/97: CD4 count of 200 - 700 cells/mm3 within 60 days prior to study entry. AS PER AMENDMENT 10/1/97: HIV RNA plasma level < 20,000 copies/ml within 60 days of enrollment (obtained at a laboratory certified to perform the Roche Monitor assay). Exclusion Criteria Co-existing Condition: Patients with any of the following symptoms or conditions are excluded: CMV, MAC, toxoplasmosis, or disseminated fungal infection requiring acute or chronic therapy. Significant medical illness as determined by investigator. Active diagnosis of any malignancy, including visceral Kaposi's sarcoma or extensive cutaneous Kaposi's sarcoma for which systemic chemotherapy is anticipated within the next 24 weeks. Current Grade 2 or greater peripheral neuropathy. Concurrent Medication: Excluded: Acute or chronic therapy for CMV, MAC, toxoplasmosis, or disseminated fungal infection. AS PER AMENDMENT 5/5/97: All antiretroviral medications other than those provided on study. Systemic chemotherapy for active malignancies, including systemic treatment for KS. Agents with myelosuppressive potential, including tegretol, carboplatin, carmustine, cyclophosphamide and fluorouracil. Granulocyte colony stimulating factor (G-CSF) except while hydroxyurea or matching placebo is held. Drugs associated with peripheral neuropathy, including: hydralazine, disulfiram, nitrofurantoin, cisplatinum, diethyldithiocarbamate, gold, rifampin, chloramphenicol, clioquinol, ethambutol, ethionamide, glutethimide, sodium cyanate, and thalidomide. Patients with any of the prior conditions are excluded: History of transfusion dependent anemia, defined as any history of repeated transfusion with two or more units of red blood cells. At the discretion of the investigator, history of pancreatitis. Prior Medication: Excluded: More than 2 weeks prior treatment with ddI. AS PER AMENDMENT 5/5/97: Other antiretrovirals must be discontinued at least 14 days prior to randomization. Prior hydroxyurea. Any candidate HIV vaccine or agent with potential immune modulating effects within the past 30 days. Any colony stimulating factor or erythropoietin within the past 60 days. Prior Treatment: Excluded: Transfusion with red blood cells within the past 60 days. Risk Behavior: Excluded: At the investigator's discretion, any active substance abuse, including alcohol abuse interfering with compliance.

Sites / Locations

  • Univ of California / San Diego Treatment Ctr
  • Stanford at Kaiser / Kaiser Permanente Med Ctr
  • Stanford Univ Med Ctr
  • Harbor UCLA Med Ctr
  • Univ of Colorado Health Sciences Ctr
  • Johns Hopkins Hosp
  • Beth Israel Med Ctr
  • Bellevue Hosp / New York Univ Med Ctr
  • Mount Sinai Med Ctr
  • Univ of North Carolina
  • Duke Univ Med Ctr
  • Univ of Cincinnati
  • Case Western Reserve Univ
  • MetroHealth Med Ctr
  • Univ of Pennsylvania at Philadelphia
  • Thomas Jefferson Univ Hosp
  • Julio Arroyo
  • Univ of Washington

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
October 28, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT00001074
Brief Title
The Safety and Effectiveness of Hydroxyurea and ddI Used Individually or Together in HIV-Infected Patients
Official Title
A Phase I/II Dosing Study of the Safety and Antiretroviral Activity of Hydroxyurea Alone and in Combination With ddI Compared With ddI Alone in Subjects With HIV Infection
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
January 2000 (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 determine the safety and tolerability of hydroxyurea at two doses alone and in combination with didanosine (ddI). To compare the short term antiviral effect of ddI monotherapy versus hydroxyurea plus ddI, as measured by plasma RNA levels at 8 weeks of therapy. [AS PER AMENDMENT 10/1/97: Accrual to arms involving hydroxyurea alone has been closed.] Current antiviral therapies for HIV-1 are limited by a few choices, and the lack of sustained clinical benefit from the drugs. The mechanisms that account for the lack of prolonged inhibition of viral replication by these agents are not fully understood. The activity of RT inhibitors might be potentiated by inhibiting host cellular enzymes essential for efficient HIV reverse transcription. Based on this information, comparisons of the antiviral effects of ddI monotherapy and hydroxyurea plus ddI, with the cellular enzyme ribonucleotide reductase as a potential target, should be done.
Detailed Description
Current antiviral therapies for HIV-1 are limited by a few choices, and the lack of sustained clinical benefit from the drugs. The mechanisms that account for the lack of prolonged inhibition of viral replication by these agents are not fully understood. The activity of RT inhibitors might be potentiated by inhibiting host cellular enzymes essential for efficient HIV reverse transcription. Based on this information, comparisons of the antiviral effects of ddI monotherapy and hydroxyurea plus ddI, with the cellular enzyme ribonucleotide reductase as a potential target, should be done. This is a 24-week study, with two 12-week treatment periods. Patients are randomized to one of five treatment arms based upon a patient's history of antiretroviral therapy (naive vs. experienced). The five treatment arms are: ddI plus hydroxyurea placebo. hydroxyurea (lower dose) plus ddI placebo for 4 weeks; then hydroxyurea (higher dose) plus ddI. hydroxyurea (higher dose) plus ddI placebo for 4 weeks; then hydroxyurea (higher dose) plus ddI. hydroxyurea (lower dose) plus ddI. hydroxyurea (higher dose) plus ddI. After the completion of week 12, patients on combination therapy remain on their current therapy and patients on ddI plus placebo have hydroxyurea replace the placebo at 1 of 2 assigned doses (1:1 randomization). AS PER AMENDMENT 5/5/97: If after the 24-week treatment period, a patient has an RNA level less than or equal to 5,000 copies/ml or less than 20,000 copies/ml with a greater than 1 log10 decline from baseline, she has the option to continue therapy open-label ddI plus hydroxyurea for an additional 24 weeks. AS PER AMENDMENT 10/1/97: Accrual to the arms involving hydroxyurea alone has been closed. Patients are randomized to one of the three treatment arms, as follows: hydroxyurea placebo plus ddI. hydroxyurea (lower dose) plus ddI. hydroxyurea (higher dose) plus ddI.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Didanosine, Drug Therapy, Combination, Antiviral Agents, Hydroxyurea

7. Study Design

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

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Hydroxyurea
Intervention Type
Drug
Intervention Name(s)
Didanosine

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed: AS PER AMENDMENT 5/5/97: PCP prophylaxis with trimethoprim/sulfamethoxazole or Dapsone. Patients must have: HIV-1 infection. AS PER AMENDMENT 5/5/97: CD4 count of 200 - 700 cells/mm3 within 60 days prior to study entry. AS PER AMENDMENT 10/1/97: HIV RNA plasma level < 20,000 copies/ml within 60 days of enrollment (obtained at a laboratory certified to perform the Roche Monitor assay). Exclusion Criteria Co-existing Condition: Patients with any of the following symptoms or conditions are excluded: CMV, MAC, toxoplasmosis, or disseminated fungal infection requiring acute or chronic therapy. Significant medical illness as determined by investigator. Active diagnosis of any malignancy, including visceral Kaposi's sarcoma or extensive cutaneous Kaposi's sarcoma for which systemic chemotherapy is anticipated within the next 24 weeks. Current Grade 2 or greater peripheral neuropathy. Concurrent Medication: Excluded: Acute or chronic therapy for CMV, MAC, toxoplasmosis, or disseminated fungal infection. AS PER AMENDMENT 5/5/97: All antiretroviral medications other than those provided on study. Systemic chemotherapy for active malignancies, including systemic treatment for KS. Agents with myelosuppressive potential, including tegretol, carboplatin, carmustine, cyclophosphamide and fluorouracil. Granulocyte colony stimulating factor (G-CSF) except while hydroxyurea or matching placebo is held. Drugs associated with peripheral neuropathy, including: hydralazine, disulfiram, nitrofurantoin, cisplatinum, diethyldithiocarbamate, gold, rifampin, chloramphenicol, clioquinol, ethambutol, ethionamide, glutethimide, sodium cyanate, and thalidomide. Patients with any of the prior conditions are excluded: History of transfusion dependent anemia, defined as any history of repeated transfusion with two or more units of red blood cells. At the discretion of the investigator, history of pancreatitis. Prior Medication: Excluded: More than 2 weeks prior treatment with ddI. AS PER AMENDMENT 5/5/97: Other antiretrovirals must be discontinued at least 14 days prior to randomization. Prior hydroxyurea. Any candidate HIV vaccine or agent with potential immune modulating effects within the past 30 days. Any colony stimulating factor or erythropoietin within the past 60 days. Prior Treatment: Excluded: Transfusion with red blood cells within the past 60 days. Risk Behavior: Excluded: At the investigator's discretion, any active substance abuse, including alcohol abuse interfering with compliance.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ian Frank, MD
Organizational Affiliation
Division of Infectious Diseases, University of Pennsylvania
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Joseph Eron, MD
Organizational Affiliation
University of North Carolina
Official's Role
Study Chair
Facility Information:
Facility Name
Univ of California / San Diego Treatment Ctr
City
San Diego
State/Province
California
ZIP/Postal Code
921036325
Country
United States
Facility Name
Stanford at Kaiser / Kaiser Permanente Med Ctr
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
Stanford Univ Med Ctr
City
Stanford
State/Province
California
ZIP/Postal Code
943055107
Country
United States
Facility Name
Harbor UCLA Med Ctr
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
Univ of Colorado Health Sciences Ctr
City
Denver
State/Province
Colorado
ZIP/Postal Code
80262
Country
United States
Facility Name
Johns Hopkins Hosp
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Beth Israel Med Ctr
City
New York
State/Province
New York
ZIP/Postal Code
10003
Country
United States
Facility Name
Bellevue Hosp / New York Univ Med Ctr
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Mount Sinai Med Ctr
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Univ of North Carolina
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
275997215
Country
United States
Facility Name
Duke Univ Med Ctr
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Univ of Cincinnati
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
452670405
Country
United States
Facility Name
Case Western Reserve Univ
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
MetroHealth Med Ctr
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
441091998
Country
United States
Facility Name
Univ of Pennsylvania at Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Thomas Jefferson Univ Hosp
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
191075098
Country
United States
Facility Name
Julio Arroyo
City
West Columbia
State/Province
South Carolina
ZIP/Postal Code
29169
Country
United States
Facility Name
Univ of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
981224304
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Frank I, Boucher H, Fiscus S, Flexner C, Valentine F, Gulick R, Fox L, Eron J. Phase I/II dosing study of once-daily hydroxyurea (HU) alone vs didanosine (ddI) alone vs ddI + HU. Conf Retroviruses Opportunistic Infect. 1999 Jan 31-Feb 4;6th:143 (abstract no 402)
Results Reference
result
PubMed Identifier
15597521
Citation
Frank I, Bosch RJ, Fiscus S, Valentine F, Flexner C, Segal Y, Ruan P, Gulick R, Wood K, Estep S, Fox L, Nevin T, Stevens M, Eron JJ Jr; ACTG 307 Protocol Team. Activity, safety, and immunological effects of hydroxyurea added to didanosine in antiretroviral-naive and experienced HIV type 1-infected subjects: a randomized, placebo-controlled trial, ACTG 307. AIDS Res Hum Retroviruses. 2004 Sep;20(9):916-26. doi: 10.1089/aid.2004.20.916.
Results Reference
result

Learn more about this trial

The Safety and Effectiveness of Hydroxyurea and ddI Used Individually or Together in HIV-Infected Patients

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