Completed

Phase 2
Age: 13Years +
All Genders
ID00000781

A Randomized, Double-Blind, Four-Arm Study Comparing Combination Nucleoside, Alternating Nucleoside, and Triple-Drug Therapy for the Treatment of Advanced HIV Disease (CD4 <= 50/mm3)

Led by National Institute of Allergy and Infectious Diseases (NIAID) · Updated on 2021-11-04

1292

Participants Needed

96

Research Sites

N/A

Total Duration

On this page

Sponsors

N

National Institute of Allergy and Infectious Diseases (NIAID)

Lead Sponsor

B

Bristol-Myers Squibb

Collaborating Sponsor

AI-Summary

What this Trial Is About

To determine the relative clinical efficacy of zidovudine ( AZT ) plus didanosine (ddI), AZT plus zalcitabine ( ddC ), AZT alternating monthly with ddI, and AZT/ddI plus nevirapine in HIV-infected patients with advanced disease. The rapid emergence of resistant HIV strains has been observed in patients receiving monotherapy with a nucleoside analog or non-nucleoside reverse transcriptase inhibitor. Use of combination therapy with two nucleoside drugs or convergent combination therapy with two nucleosides and a non-nucleoside RT inhibitor may minimize the evolution of these resistant HIV strains. Since toxicity is a major problem in patients with advanced disease who are receiving combination nucleoside therapy, alternating the two drugs may provide a way of retaining several benefits of combination therapy while minimizing the increased toxicity.

CONDITIONS

Official Title

A Randomized, Double-Blind, Four-Arm Study Comparing Combination Nucleoside, Alternating Nucleoside, and Triple-Drug Therapy for the Treatment of Advanced HIV Disease (CD4 <= 50/mm3)

Who Can Participate

Age: 13Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

Inclusion Criteria

Concurrent Medication:

Required:

  • PCP prophylaxis.

Allowed:

  • Erythropoietin maintenance.
  • G-CSF and GM-CSF.
  • Prophylaxis for Mycobacterium avium intracellulare.
  • Antifungal prophylaxis or treatment with specific drugs.
  • Maintenance therapy for opportunistic infection.
  • Over-the-counter medications or alternative therapies such as vitamins and herbs.
  • Antibiotics as clinically indicated.
  • Steroids for < 21 days for acute problems.
  • Antipyretics, analgesics, allergy medication, antidepressants, sleep medications, oral contraceptives, or other appropriate medications.

Concurrent Treatment:

Allowed:

  • Radiation therapy for cutaneous Kaposi's sarcoma.
  • Acupuncture.

Patients must have:

  • Documented HIV infection.
  • CD4 count <= 50 cells/mm3.
  • Either no prior nucleoside therapy OR a history of prior nucleoside therapy in the absence of high-grade intolerance.
  • Life expectancy of at least 6 months.
  • Consent of parent or guardian if < 18 years of age.
  • Normal chest x-ray at baseline or within 6 months prior to study entry in the absence of new pulmonary or cardiac symptoms (per 12/28/94 amendment).

NOTE:

  • Patients who withdrew from protocol ACTG 193 therapy prior to activation of ACTG 193A are not eligible.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

  • Abnormal baseline chest x-ray.
  • New pulmonary or cardiac symptoms.
  • Psychological or emotional problems sufficient to prevent compliance with study medication.

Concurrent Medication:

Excluded:

  • Systemic chemotherapy for malignancy.
  • Acute or induction therapy for opportunistic infection.
  • Antiretroviral drugs other than study drugs.
  • Biological response modifiers.
  • Erythromycin, phenytoin, phenobarbital, warfarin, or coumadin.

Patients with the following prior conditions are excluded:

  • History of recurrent grade 3 or greater toxicity to AZT, ddI, or ddC on two or more occasions.
  • Evidence of active pulmonary disease within 6 months prior to study entry.
  • History of grade 3 or worse peripheral neuropathy.
  • History of acute or chronic pancreatitis.

Prior Medication:

Excluded:

  • Prior nevirapine.

Excluded within 7 days prior to study entry:

  • Acute therapy for opportunistic infection (maintenance therapy is permitted).
  • Acute systemic therapy for a nonopportunistic infection or other medical condition.
  • Antiretroviral drugs other than AZT, ddI, or ddC.
  • Biological response modifiers.
  • d4T therapy.
  • Nucleosides other than those used in the study.
  • Antibiotics containing clavulanate potassium.

Prior Treatment:

Excluded:

  • More than 4 units of blood in a 30-day period.

Active alcohol or drug abuse.

Not Eligible

You will not qualify if you...

History of severe allergic reactions to study medication Currently pregnant or breastfeeding Recent participation in another clinical trial within the last 30 days Presence of uncontrolled medical conditions that could affect safety

Trial Site Locations

Total: 96 locations

1

Univ of Alabama at Birmingham

Birmingham, Alabama, United States, 35294

Status Unknown

2

Children's Hosp of Los Angeles

Los Angeles, California, United States, 90027

Status Unknown

3

Univ of Southern California / LA County USC Med Ctr

Los Angeles, California, United States, 900331079

Status Unknown

4

Huntington Memorial Hosp / Children's Hosp of Los Angeles

Pasadena, California, United States, 91105

Status Unknown

5

Univ of California / San Diego Treatment Ctr

San Diego, California, United States, 921036325

Status Unknown

6

San Francisco AIDS Clinic / San Francisco Gen Hosp

San Francisco, California, United States, 941102859

Status Unknown

7

San Francisco Gen Hosp

San Francisco, California, United States, 941102859

Status Unknown

8

Stanford at Kaiser / Kaiser Permanente Med Ctr

San Francisco, California, United States, 94115

Status Unknown

9

Santa Clara Valley Med Ctr / AIDS Community Rsch Consortium

San Jose, California, United States, 951282699

Status Unknown

10

San Mateo AIDS Program / Stanford Univ

Stanford, California, United States, 943055107

Status Unknown

11

Stanford Univ Med Ctr

Stanford, California, United States, 943055107

Status Unknown

12

Olive View Med Ctr

Sylmar, California, United States, 91342

Status Unknown

13

Harbor UCLA Med Ctr

Torrance, California, United States, 90502

Status Unknown

14

Denver Dept of Health and Hosps

Denver, Colorado, United States, 80262

Status Unknown

15

Mountain States Reg Hemo Ctr / Univ of Colorado

Denver, Colorado, United States, 80262

Status Unknown

16

Rose Med Ctr

Denver, Colorado, United States, 80262

Status Unknown

17

Univ of Colorado Health Sciences Ctr

Denver, Colorado, United States, 80262

Status Unknown

18

Yale Univ / New Haven

New Haven, Connecticut, United States, 065102483

Status Unknown

19

HIV Ctr - District of Columbia Gen Hosp

Washington D.C., District of Columbia, United States, 200072197

Status Unknown

20

Whitman - Walker Clinic / Georgetown Univ Med Ctr

Washington D.C., District of Columbia, United States, 200072197

Status Unknown

21

Georgetown Univ Med Ctr

Washington D.C., District of Columbia, United States, 20007

Status Unknown

22

George Washington Univ / Hershey Med Ctr

Washington D.C., District of Columbia, United States, 20037

Status Unknown

23

Howard Univ

Washington D.C., District of Columbia, United States, 20059

Status Unknown

24

Univ of Miami School of Medicine

Miami, Florida, United States, 331361013

Status Unknown

25

Univ of South Florida

Tampa, Florida, United States, 33612

Status Unknown

26

Univ of Hawaii

Honolulu, Hawaii, United States, 96816

Status Unknown

27

Northwestern Univ Med School

Chicago, Illinois, United States, 60611

Status Unknown

28

Cook County Hosp

Chicago, Illinois, United States, 60612

Status Unknown

29

Rush Presbyterian - Saint Luke's Med Ctr

Chicago, Illinois, United States, 60612

Status Unknown

30

Louis A Weiss Memorial Hosp

Chicago, Illinois, United States, 60640

Status Unknown

31

Indiana Univ Hosp

Indianapolis, Indiana, United States, 462025250

Status Unknown

32

Methodist Hosp of Indiana / Life Care Clinic

Indianapolis, Indiana, United States, 46202

Status Unknown

33

Univ of Louisville / East Tennesee Comprehensive Hem Ctr

Louisville, Kentucky, United States, 40202

Status Unknown

34

Harvard (Massachusetts Gen Hosp)

Boston, Massachusetts, United States, 02114

Status Unknown

35

Boston Med Ctr

Boston, Massachusetts, United States, 02118

Status Unknown

36

Beth Israel Deaconess - West Campus

Boston, Massachusetts, United States, 02215

Status Unknown

37

Worcester Memorial Hosp / Med Ctr of Cntrl MA-Memorial

Worcester, Massachusetts, United States, 01605

Status Unknown

38

Hennepin County Med Clinic

Minneapolis, Minnesota, United States, 55415

Status Unknown

39

Univ of Minnesota

Minneapolis, Minnesota, United States, 55455

Status Unknown

40

St Paul Ramsey Med Ctr

Saint Paul, Minnesota, United States, 55101

Status Unknown

41

St Louis Regional Hosp / St Louis Regional Med Ctr

St Louis, Missouri, United States, 63112

Status Unknown

42

Univ of Nebraska Med Ctr

Omaha, Nebraska, United States, 681985130

Status Unknown

43

Dartmouth - Hitchcock Med Ctr / Med Ctr Cntrl Massachusetts

Lebanon, New Hampshire, United States, 03756

Status Unknown

44

Robert Wood Johnson Med School / Hershey Med Ctr

New Brunswick, New Jersey, United States, 08903

Status Unknown

45

Univ of Medicine & Dentistry of New Jersey / Univ Hosp

Newark, New Jersey, United States, 071032714

Status Unknown

46

Adirondack Med Ctr at Saranac Lake

Albany, New York, United States, 122083479

Status Unknown

47

Albany Med College / Division of HIV Medicine A158

Albany, New York, United States, 122083479

Status Unknown

48

Mid - Hudson Care Ctr

Albany, New York, United States, 122083479

Status Unknown

49

SUNY / Health Sciences Ctr at Brooklyn

Brooklyn, New York, United States, 112032098

Status Unknown

50

SUNY / Erie County Med Ctr at Buffalo

Buffalo, New York, United States, 14215

Status Unknown

51

City Hosp Ctr at Elmhurst / Mount Sinai Hosp

Elmhurst, New York, United States, 11373

Status Unknown

52

North Shore Univ Hosp

Manhasset, New York, United States, 11030

Status Unknown

53

Beth Israel Med Ctr

New York, New York, United States, 10003

Status Unknown

54

Bellevue Hosp / New York Univ Med Ctr

New York, New York, United States, 10016

Status Unknown

55

Saint Clare's Hosp and Health Ctr

New York, New York, United States, 10019

Status Unknown

56

Cornell Univ Med Ctr

New York, New York, United States, 10021

Status Unknown

57

Mem Sloan - Kettering Cancer Ctr

New York, New York, United States, 10021

Status Unknown

58

Mount Sinai Med Ctr / Hemophilia Treatment Ctr

New York, New York, United States, 10029

Status Unknown

59

Mount Sinai Med Ctr

New York, New York, United States, 10029

Status Unknown

60

Columbia Presbyterian Med Ctr

New York, New York, United States, 100323784

Status Unknown

61

Harlem Hosp Ctr

New York, New York, United States, 10037

Status Unknown

62

Univ of Rochester Medical Center

Rochester, New York, United States, 14642

Status Unknown

63

SUNY / State Univ of New York

Syracuse, New York, United States, 13210

Status Unknown

64

Bronx Municipal Hosp Ctr/Jacobi Med Ctr

The Bronx, New York, United States, 10461

Status Unknown

65

Comprehensive Health Care Ctr / Bronx Municipal Hosp

The Bronx, New York, United States, 10461

Status Unknown

66

Montefiore Drug Treatment Ctr / Bronx Municipal Hosp

The Bronx, New York, United States, 10461

Status Unknown

67

Montefiore Family Health Ctr / Bronx Municipal Hosp

The Bronx, New York, United States, 10461

Status Unknown

68

Samaritan Village Inc / Bronx Municipal Hosp

The Bronx, New York, United States, 10461

Status Unknown

69

Jack Weiler Hosp / Bronx Municipal Hosp

The Bronx, New York, United States, 10465

Status Unknown

70

Montefiore Med Ctr / Bronx Municipal Hosp

The Bronx, New York, United States, 10467

Status Unknown

71

Montefiore Med Ctr Adolescent AIDS Program

The Bronx, New York, United States, 10467

Status Unknown

72

North Central Bronx Hosp / Bronx Municipal Hosp

The Bronx, New York, United States, 10467

Status Unknown

73

Bronx Veterans Administration / Mount Sinai Hosp

The Bronx, New York, United States, 10468

Status Unknown

74

Univ of North Carolina

Chapel Hill, North Carolina, United States, 275997215

Status Unknown

75

Moses H Cone Memorial Hosp

Greensboro, North Carolina, United States, 27401

Status Unknown

76

Univ of Cincinnati

Cincinnati, Ohio, United States, 452670405

Status Unknown

77

Univ of Kentucky Lexington

Cincinnati, Ohio, United States, 45267

Status Unknown

78

Case Western Reserve Univ

Cleveland, Ohio, United States, 44106

Status Unknown

79

MetroHealth Med Ctr

Cleveland, Ohio, United States, 441091998

Status Unknown

80

Columbus Children's Hosp

Columbus, Ohio, United States, 432052696

Status Unknown

81

Med College of Ohio

Toledo, Ohio, United States, 43699

Status Unknown

82

Milton S Hershey Med Ctr

Hershey, Pennsylvania, United States, 170330850

Status Unknown

83

Saint Michael's Med Ctr / Milton S Hershey Med Ctr

Hershey, Pennsylvania, United States, 170330850

Status Unknown

84

Girard Med Ctr

Philadelphia, Pennsylvania, United States, 191046073

Status Unknown

85

Univ of Pennsylvania at Philadelphia

Philadelphia, Pennsylvania, United States, 19104

Status Unknown

86

Thomas Jefferson Univ Hosp

Philadelphia, Pennsylvania, United States, 191075098

Status Unknown

87

Med Univ of South Carolina / UNC

Charleston, South Carolina, United States, 29425

Status Unknown

88

Julio Arroyo

West Columbia, South Carolina, United States, 29169

Status Unknown

89

Univ of Tennessee / E Tennessee Comprehensive Hemophilia Ctr

Knoxville, Tennessee, United States, 37920

Status Unknown

90

Meharry Med College

Nashville, Tennessee, United States, 37203

Status Unknown

91

Univ of Texas Galveston

Galveston, Texas, United States, 775550435

Status Unknown

92

Univ Texas Health Science Ctr / Univ Texas Med School

Houston, Texas, United States, 77030

Status Unknown

93

Univ of Washington

Seattle, Washington, United States, 981224304

Status Unknown

94

Northern Wisconsin Hemophilia Ctr / Saint Vincent's Hosp

Green Bay, Wisconsin, United States, 54301

Status Unknown

95

Great Lakes Hemophilia Foundation

Wauwatosa, Wisconsin, United States, 532130127

Status Unknown

96

Univ of Puerto Rico

San Juan, Puerto Rico, 009365067

Status Unknown

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How is the study designed?

Study Type

INTERVENTIONAL

Masking

DOUBLE

Allocation

N/A

Model

N/A

Primary Purpose

TREATMENT

Number of Arms

0

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