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Study of Interleukin II Plus Continuous or Interrupted Antiretroviral Therapy in HIV-Infected Patients
This study is currently recruiting participants.
Verified by National Institutes of Health Clinical Center (CC), May 2008
Sponsored by: National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by: National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier: NCT00359749
  Purpose

This study, known as OPTICA, is an umbrella protocol for several ongoing NIH studies of IL-2 therapy in HIV-1 infection. Some HIV-infected patients have a higher increase in CD4+ lymphocytes after taking IL-2 than if they were taking antiretroviral drugs alone. The current study will continue to examine the possible role of this drug in helping protect against HIV damage to the immune system or restoring lost immune function. OPTICA's purpose is to consolidate the earlier trials, placing patients into a single, more uniform schedule of clinic visits and to standardize rules governing when IL-2 cycles should be given and when CD4 counts and viral loads should be re-checked.

HIV-infected patients who are currently enrolled in a NIAID/CCMD trial offering IL-2 treatment and who wish to continue their participation in this research are eligible for this study. In addition, patients 21 years of age or older who are not currently enrolled in a trial but who are of unique research interest may be eligible.

The current study requires that patients taking IL-2 must also take antiretroviral medications at least during their IL-2 cycles. Patients will be encouraged to continue taking antiretroviral drugs throughout the study, but will only be required to do so during a 10-day period around each IL-2 cycle (e.g., 3 days before, 5 days during, and 2 days after IL-2 administration). Patients will be monitored periodically with blood tests to measure viral load and lymphocyte counts and routine laboratory tests for safety. In addition, they may be asked to undergo leukapheresis, a procedure for collecting large numbers of white cells for special virologic and immunologic research tests. IL-2 will be given twice a day subcutaneously (under the skin) instead of intravenously (through a vein), on an outpatient basis, unless safety or effectiveness is compromised. Patients who qualify for home administration of IL-2 will be excluded from the outpatient requirement.

Patients with CD4 counts above 500 cells/microliter may be asked to participate in an OPTICA sub-study for determining if IL-2 therapy can preserve CD4 counts at a high enough level to allow patients to interrupt antiretroviral treatment for several months at a time. It would compare patients who remain on continuous antiretroviral therapy with those whose therapy is interrupted.

The number and frequency of patients' IL-2 cycles and the schedule of follow-up clinic visits will be based on the individual's response to therapy and need for blood tests. In general, patients who have received IL-2 for less than 1 year will be asked to return monthly; those who have been doing well on therapy for more than a year may return no more than every 2 months, and those who are particularly stable may be scheduled as infrequently as every 4 to 6 months. The study duration is open-ended, with each participant's case reviewed periodically to determine if it is safe and reasonable to remain on the protocol.


Condition Intervention Phase
AIDS
Drug: Interleukin 2
Phase II

MedlinePlus related topics: AIDS
Drug Information available for: Aldesleukin Interleukin-2
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label, Single Group Assignment, Safety/Efficacy Study
Official Title: An Omnibus Proleukin (IL-2) Trial in HIV-Infected Patients Including Interrupted Versus Continuous Antiretrovirals (OPTICA): A Substudy of Interrupted Versus Continuous Antiretrovirals Involving Randomization From the Umbrella Study (ICARUS)

Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • Long-term safety and efficacy of intermittent cycles of interleukin-2 plus HAART [ Time Frame: Until study completion ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 400
Study Start Date: August 2001
Intervention Details:
    Drug: Interleukin 2
    5-day cycles of subcutaneous interleukin-2 on an intermittent basis as determined by a fall in CD4+ cell counts between individualized target thresholds and patients' willingness to cycle
Detailed Description:

Over the past decade NIAID has sponsored a number of important phase I-II studies of IL-2 therapy in HIV-1 infection, many of which remain ongoing at this time. More recently, explorations of the safety and potential value of structured treatment interruptions (STI) of HAART in HIV-infected patients have also been undertaken. The current protocol consists of an umbrella protocol called OPTICA in which the earlier trials will be consolidated and in which prior IL-2 protocol participants or, rarely, new IL-2 recipients will be managed according to a common long-term treatment algorithm. Included in this protocol is optional participation in a randomized, controlled substudy of STI in previous IL-2 recipients called ICARUS whose goal is to determine whether sc IL-2 therapy can be used successfully as a HAART-sparing strategy.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria
  • OPTICA - INCLUSION CRITERIA: For patients new to IL-2 therapy who are not rolling over from participation in an earlier NIAID/CCMD IL-2 trial.

Documentation of HIV-1 infection by any licensed ELISA test kit and confirmed by a second method (e.g., Western Blot); or by HIV culture, plasma HIV RNA, or proviral HIV DNA.

Absolute CD4+ cell count: there is not a minimum CD4+ cell entry criterion.

Viral Load: there is no viral load restriction upon study entry.

Age greater than or equal to 18 years.

Patients must be of unique immunologic interest or are being recruited to address a research question requiring patients not presently or previously treated with IL-2.

The following laboratory values must be met within 30 days prior to entry:

  1. AST no more than 5 X the upper limit of normal (ULN).
  2. Total or direct bilirubin no more than 2 X ULN unless there is a pattern consistent with Gilbert's syndrome or the patient is receiving indinavir or atazanavir.
  3. Serum creatinine no more than 2.0 mg/dL.
  4. Hct greater than or equal to 30.0%.
  5. Platelet count greater than or equal to 50,000/mm(3).

    Willing to take combination ARV medication at least within a 10-day period surrounding each IL-2 cycle unless or until the protocol is modified to permit IL-2 therapy in the absence of any ARV coverage.

    Able to provide written informed consent.

    Because the impact of IL-2 on fertility and/or offspring is unknown, all patients, both male and female, must be willing to practice effective birth control at least during a 10-day period surrounding each IL-2 cycle while in the study.

    Cycle frequency: There is no minimum requirement for IL-2 cycle frequency. However, a reasonable expectation should exist that IL-2-treated patients will remain willing to accept additional IL-2 therapy when needed.

    OPTICA - EXCLUSION CRITERIA:

    A history of gross noncompliance with prior NIAID/CCMD protocol requirements that, in the opinion of the Principal Investigator, is likely to seriously compromise the safety or value of an individual's participation in the present protocol.

    Any organic CNS abnormality that requires treatment with anti-seizure medication.

    Current or historical Crohn's disease, psoriasis, or other autoimmune/inflammatory diseases with potentially life threatening complications.

    Significant cardiac, pulmonary, kidney, rheumatologic, gastrointestinal, or CNS disease as detectable on routine history, physical examination, or screening laboratory studies that, in the judgment of the Principle Investigator, may pose an unacceptable risk during subsequent IL-2 therapy.

    Psychiatric illness that, in the judgement of the Principal Investigator, might interfere with study compliance or poses a significant risk for exacerbation during subsequent IL-2 therapy.

    Recent or active substance abuse that may interfere with protocol compliance or compromise patient safety.

    Refusal to practice safer sex or use precautions against pregnancy (effective birth control or abstinence) during cycling.

    Refusal to follow Clinical Center policy on partner notification.

    History of optic neuritis.

    Refusal to permit extra research blood specimens to be stored (frozen) for potential use in the future study of HIV-1 infection or the immune system.

    ICARUS - INCLUSION CRITERIA: For patients who are rolling over from participation in an earlier NIAID/CCMD IL-2 trial

    Prior documentation of HIV-1 infection by any licensed ELISA test kit and confirmed by a second method (e.g., Western Blot); or by HIV culture, plasma HIV RNA, or proviral HIV DNA.

    Absolute CD4+ count: there is not a minimum CD4+ cel entry criterion.

    Viral load: there is no viral load restriction upon study entry.

    Age at least 18 years.

    Current participation, and presently in good standing, in an NIAID/CCMD protocol involving the use of IL-2 in the treatment of HIV-1 infection.

    If eligibilble for IL-2 therapy, willing to take combination ARV medication at least within a 10-day period surrounding each IL-2 cycle unless or until the protocol is modified to permit IL-2 therapy in the absence of any ARV coverage.

    Able to provide written informed consent.

    Both male and females must be willing to practice effective birth control at least during a 10-day period surrounding each IL-2 cycle while in the study.

    Cycle frequency: There is no minimum requirement for IL-2 cycle frequency.

    ICARUS - EXCLUSION CRITERIA:

    A history of gross noncompliance with prior NIAID/CCMD protocol requirements that, in the opinion of the Principal Investigator, is likely to seriously compromise the safety or value of an individual's participation in the present protocol.

    Any organic CNS abnormality that requires treatment with anti-seizure medication.

    Unless previously exempted for this requirement, current or historical Crohn's disease, psoriasis, or other autoimmune/inflammatory diseases with potentially life-threatening complications.

    Recent or active substance abuse that may interfere with protocol compliance or compromise patient safety.

    Refusal to practice safer sex or use precautions against pregnancy (effective birth control or abstinence) during cycling.

    Refusal to follow Clinical Center policy on partner notification.

    History of optic neuritis.

    Refusal to permit extra research blood specimens to be stored (frozen) for potential use in the future study of HIV-1 infection or the immune system.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00359749

Contacts
Contact: Patient Recruitment and Public Liaison Office (800) 411-1222 prpl@mail.cc.nih.gov
Contact: TTY 1-866-411-1010

Locations
United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike Recruiting
Bethesda, Maryland, United States, 20892
Sponsors and Collaborators
  More Information

NIH Clinical Center Detailed Web Page  This link exits the ClinicalTrials.gov site

Publications:
Responsible Party: ( DAIDS, NIAID )
Study ID Numbers: 010225, 01-I-0225
Study First Received: August 1, 2006
Last Updated: October 6, 2008
ClinicalTrials.gov Identifier: NCT00359749  
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Immune Based
Cytokine
AIDS
Antiretroviral
HIV
AIDS
IL-2

Study placed in the following topic categories:
Aldesleukin
Interleukin-2
HIV Infections
Acquired Immunodeficiency Syndrome

Additional relevant MeSH terms:
Sensory System Agents
Analgesics, Non-Narcotic
Antineoplastic Agents
Therapeutic Uses
Physiological Effects of Drugs
Peripheral Nervous System Agents
Analgesics
Central Nervous System Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009