Overview

A Study of ddC in Patients With AIDS or Advanced AIDS-Related Complex (ARC) Who Have Not Had Success With Zidovudine (AZT)

Status:
Completed
Trial end date:
1969-12-31
Target enrollment:
0
Participant gender:
All
Summary
AMENDED: To provide ddC for patients with AIDS or advanced ARC who have failed treatment with, are intolerant to or are ineligible to receive zidovudine (AZT) and to demonstrate that ddC monotherapy is safe, and tolerable in this patient population. Original design: To provide zalcitabine (dideoxycytidine; ddC) for patients with AIDS or advanced AIDS-related complex (ARC) who have failed treatment with or are intolerant to zidovudine (AZT) and who are also intolerant to dideoxyinosine (ddI); to demonstrate that ddC monotherapy is safe and tolerable in the treatment of patients who previously experienced either treatment failure, hematologic intolerance or myositis with AZT treatment and pancreatitis or other toxicities (except peripheral neuropathy with ddI).
Phase:
N/A
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Hoffmann-La Roche
Treatments:
Zalcitabine
Zidovudine
Criteria
Inclusion Criteria

Concurrent Medication:

Recommended:

- Aerosolized Pentamidine or other prophylaxis against Pneumocystis carinii pneumonia
(PCP).

- Allowed:

- Drugs or treatments that could cause other serious additive toxicity when
coadministered with study medication will be allowed for treatment of an acute
intercurrent illness or opportunistic infection at the discretion of the investigator.

- Isoniazid, if there is no evidence of peripheral neuropathy at entry and the patient
is taking pyridoxine = or > 50 mg/day.

- Metronidazole, only with a study drug interruption; neurological exam should be
performed before and after treatment with metronidazole and ddC restarted only if
there are no signs, symptoms or neurological findings suggestive of peripheral
neuropathy.

- It is recommended that patients requiring amphotericin, pyrimethamine, sulfadiazine,
intravenous trimethoprim / sulfamethoxazole, ganciclovir, intravenous pentamidine,
intravenous acyclovir or acyclovir = or > 1000 mg/day orally or other bone marrow or
renal toxic drugs have an interruption of ddC until they are stable for two weeks on a
maintenance dose of the above medications and only then can ddC be restarted.

- Patients on amphotericin, pyrimethamine, sulfadiazine, trimethoprim /
sulfamethoxazole, ganciclovir, intravenous acyclovir or acyclovir = or > 1000 mg/day
orally or other bone marrow or renal toxic drugs may not tolerate concomitant ddC.

- If these drugs are given concomitantly with ddC, patients should have frequent
(weekly) laboratory assessments, as appropriate.

- Drugs that are nephrotoxic or have the potential to cause peripheral neuropathy might
be expected to cause increased toxicity when co-administered with ddC.

Concurrent Treatment:

Allowed:

- Radiation therapy with dideoxycytidine (ddC) interruption until stable for 2 weeks on
treatment.

AMENDED:

- Treatment categories are now:

- AZT treatment failure. AZT intolerance. AZT ineligibility

Original design:

- Patients must have a diagnosis of AIDS or AIDS-related complex (ARC) and fall into one
of the following 2 categories:

- Zidovudine (AZT) treatment failure and dideoxyinosine (ddI) intolerance or AZT
intolerance and ddI intolerance. Under 18 years of age must have the consent of a
parent or guardian.

Exclusion Criteria

Co-existing Condition:

Patients with the following conditions or symptoms are excluded:

- Any history of peripheral neuropathy due to any cause, even if peripheral neuropathy
was not the reason for discontinuation of other anti-HIV therapy.

- Any finding suggestive of peripheral neuropathy found at neurological exam. If patient
has an isolated finding of an absent achilles reflex he may be entered if no signs or
symptoms and no other findings are suggestive of peripheral neuropathy.

- Neoplasms other than Kaposi's sarcoma or basal cell carcinoma.

Concurrent Medication:

Excluded:

- Other experimental drugs.

- Other retroviral nucleoside analogs.

- Immunomodulators Systemic corticosteroids.

- Drugs with known nephrotoxic or hepatotoxic potential.

- Drugs likely to cause peripheral neuropathy.

- Avoid due to potential to cause peripheral neuropathy:

- Chloramphenicol.

- Iodoquinol.

- Phenytoin.

- Ethionamide.

- Gold.

- Ribavirin.

- Vincristine.

- Cisplatin.

- Dapsone.

- Disulfiram.

- Glutethimide.

- Hydralazine.

- Nitrofurantoin.

Patients with the following are excluded:

- Any history of peripheral neuropathy due to any cause.

- Any finding suggestive of peripheral neuropathy found at baseline neurological exam.

- Neoplasms other than Kaposi's sarcoma or basal cell carcinoma.

- Unwillingness or deemed unable to sign informed consent.