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Sponsored by: |
National Institute of Allergy and Infectious Diseases (NIAID) |
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Information provided by: | National Institute of Allergy and Infectious Diseases (NIAID) |
ClinicalTrials.gov Identifier: | NCT00000730 |
This study compares three different therapies for treatment of refractory Pneumocystis carinii pneumonia (PCP) in patients with AIDS. "Refractory" means that the patient has failed to respond to at least 4 days of treatment with either of two standard therapies: (1) sulfamethoxazole/trimethoprim (SMX/TMP) or (2) pentamidine (PEN). This study compares therapy with trimetrexate (TMTX) and leucovorin (LCV) to standard therapy and standard therapy plus high-dose steroids (methylprednisolone). The purpose is to find better and safer forms of treatment for PCP in AIDS patients. There is at present no scientific information about the best treatment for an AIDS patient with PCP who is not improving while receiving the standard therapies (SMX/TMP or PEN). New drug treatments are available, including steroid therapy and TMTX, but there is no information proving that these new treatments work better than the standard therapies.
Condition | Intervention | Phase |
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Pneumonia, Pneumocystis Carinii HIV Infections |
Drug: Trimetrexate glucuronate Drug: Methylprednisolone Drug: Pentamidine isethionate Drug: Sulfamethoxazole-Trimethoprim Drug: Leucovorin calcium |
Phase III |
Study Type: | Interventional |
Study Design: | Treatment, Randomized |
Official Title: | A Randomized, Comparative Trial of Trimetrexate With Leucovorin Rescue Versus Standard Anti-Pneumocystis Therapy Versus Standard Anti-Pneumocystis Therapy With High Dose Steroids for AIDS Patients With Pneumocystis Pneumonia Who Appear to Be Refractory to Conventional Drugs |
Estimated Enrollment: | 240 |
There is at present no scientific information about the best treatment for an AIDS patient with PCP who is not improving while receiving the standard therapies (SMX/TMP or PEN). New drug treatments are available, including steroid therapy and TMTX, but there is no information proving that these new treatments work better than the standard therapies.
Hospitalized patients who have failed to respond to at least 4 full days but no greater than 14 full days of therapy with SMX/TMP or PEN are randomly placed into one of three study groups. Patients are stratified for (1) mechanical ventilation at enrollment, (2) prior zidovudine therapy of at least 4 weeks duration, and (3) first versus subsequent episode of PCP. One group of patients receives TMTX by intravenous infusion for 21 days and LCV for 24 days. The second and third group of patients receive either PEN or SMX/TMP depending on which therapy they have already received and not improved on. The difference between the second and third group is that the second group receives the conventional therapy (PEN or SMX/TMP) and a placebo (inactive medication) and the third group receives the conventional therapy and prednisolone. Neither investigators nor patients know whether patients receive methylprednisolone. Patients continue study treatment until a study end point is reached or for a minimum of 21 days (unless there is toxicity).
Ages Eligible for Study: | 12 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria
Concurrent Medication:
Allowed:
Prior Medication:
Required:
Allowed:
Exclusion Criteria
Co-existing Condition:
Excluded:
Concurrent Medication:
Excluded:
Excluded:
Prior Medication:
Excluded within 4 days of study entry:
Study ID Numbers: | ACTG 030 |
Study First Received: | November 2, 1999 |
Last Updated: | July 29, 2008 |
ClinicalTrials.gov Identifier: | NCT00000730 |
Health Authority: | United States: Federal Government |
Trimethoprim-Sulfamethoxazole Combination Trimetrexate AIDS-Related Opportunistic Infections Pneumonia, Pneumocystis carinii Leucovorin |
Folic Acid Antagonists Acquired Immunodeficiency Syndrome Antiprotozoal Agents Sulfamethoxazole-Trimethoprim |
Opportunistic Infections Sexually Transmitted Diseases, Viral Trimethoprim Clotrimazole Methylprednisolone Miconazole Leucovorin Prednisolone acetate Trimethoprim-Sulfamethoxazole Combination Pneumonia, Pneumocystis Mycoses Respiratory Tract Diseases Respiratory Tract Infections AIDS-Related Opportunistic Infections Pentamidine |
Retroviridae Infections Trimetrexate Methylprednisolone Hemisuccinate Lung Diseases, Fungal Sulfamethoxazole Pneumocystosis Acquired Immunodeficiency Syndrome Tioconazole Methylprednisolone acetate Immunologic Deficiency Syndromes Virus Diseases Folic Acid Calcium, Dietary Pneumocystis Infections HIV Infections |
Antimetabolites Anti-Inflammatory Agents Trypanocidal Agents Anti-Infective Agents Antiprotozoal Agents Antimetabolites, Antineoplastic Slow Virus Diseases Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Physiological Effects of Drugs Hormones, Hormone Substitutes, and Hormone Antagonists Antiemetics Renal Agents Infection Neuroprotective Agents |
Hormones Antimalarials Antiparasitic Agents Antifungal Agents Therapeutic Uses Vitamins Micronutrients RNA Virus Infections Vitamin B Complex Immune System Diseases Antineoplastic Agents, Hormonal Growth Substances Gastrointestinal Agents Enzyme Inhibitors Anti-Infective Agents, Urinary |