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Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis Clinical Trials Facts presented on Clinical Trials Search is not designed to be a substitute for certified medical advice, travels to or treatment with a real dr.. We aren't doctors. Always consult your mD on Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis conditions. Clinical Trials Search.org is a website dedicated to listing clinical research studies in human subjects. Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis Clinical research trials and Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis medical trials occur in many of places across the U.S.A.. A clinical trial or clinical study is a research project with human volunteer subjects. Clinical drug trials and pharmaceutical clinical trials generally assess the effectiveness of new does drugs. The role of the studies / undertakings is to figure out certain human healthcare questions. Clinical trials are a popular means for doctors, government agencies, and private sector corporations to locate treatments for all forms of circumstances, including Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis. Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis Clinical Trials and other clinical trials permit volunteers to get medical treatment options before they are available to the masses. Most times the human subjects acquire treatment for free of charge, and sometimes they are paid for their time. Occasionally there is a cost for a Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis clinical trial. Participants oftentimes recieve the finest healthcare available for their Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis condition. Dangers are a reality, nonetheless, and might include extra or frequent physician calls, health hazards (potentially life-endangering), and/or the treatment being ineffectual. Trials are federally regulated with strict guidelines to protect clinical trials subjects.

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Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis



Phase II Randomized Open-Label Trial of Atovaquone Plus Pyrimethamine and Atovaquone Plus Sulfadiazine for the Treatment of Acute Toxoplasmic Encephalitis

For Condition: Toxoplasmosis, Cerebral,HIV Infections
Status: Completed
Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) ,
Synopsis: To evaluate the efficacy, safety, and tolerance of atovaquone with either pyrimethamine or sulfadiazine in AIDS patients with toxoplasmic encephalitis. AIDS patients with toxoplasmic encephalitis who receive the standard therapy combination of sulfadiazine and pyrimethamine experience a high frequency of severe toxicity. Atovaquone, an antibiotic that has demonstrated efficacy against toxoplasmosis in animal models and in preclinical testing has been well tolerated, is now available as a suspension, which is more readily absorbed than the tablet form of the drug. The efficacy and safety of atovaquone in combination with sulfadiazine or pyrimethamine will be studied.
Details: AIDS patients with toxoplasmic encephalitis who receive the standard therapy combination of sulfadiazine and pyrimethamine experience a high frequency of severe toxicity. Atovaquone, an antibiotic that has demonstrated efficacy against toxoplasmosis in animal models and in preclinical testing has been well tolerated, is now available as a suspension, which is more readily absorbed than the tablet form of the drug. The efficacy and safety of atovaquone in combination with sulfadiazine or pyrimethamine will be studied. Seventy patients are randomized to receive atovaquone with either pyrimethamine or sulfonamides for up to 48 weeks. Additionally, three cohorts of 10 patients each who have a history of treatment-limiting toxicity to pyrimethamine, sulfadiazine, or both drugs receive atovaquone plus the alternate drug or atovaquone plus clarithromycin. All patients receiving pyrimethamine also receive leucovorin protection. PER AMENDMENT 4/3/96: The open treatment groups are: Atovaquone plus pyrimethamine for patients with acute toxoplasmic encephalitis who have no treatment limiting toxicity to pyrimethamine, and Atovaquone plus clarithromycin for patients with acute toxoplasmic encephalitis who have treatment limiting toxicity to both pyrimethamine and sulfadiazine. The following arms closed on 12/22/95: Randomization to the atovaquone plus sulfadiazine arm for patients with acute toxoplasmic encephalitis who had no treatment limiting toxicity to pyrimethamine or sulfonamides, and Atovaquone plus sulfadiazine for patients with acute toxoplasmic encephalitis who had treatment limiting toxicity to pyrimethamine. The following arm closed on 9/26/95: Atovaquone plus pyrimethamine for patients with acute toxoplasmic encephalitis who had treatment limiting toxicity to sulfonamides. NOTE: Any patients enrolled in previous versions will continue to be treated with that same drug treatment and followed under their previous version guidelines.
Eligibility:
Study Type:
  Interventional, Treatment, Parallel Assignment, Safety Study
Minimum Age/Maximum Age: 13 Years/
Genders: Both
Protocol Entry Criteria: Inclusion Criteria Concurrent Medication: Allowed: - Aerosolized pentamidine for PCP prophylaxis. PER AMENDMENT 4/3/96: - History of treatment limiting toxicity to pyrimethamine. Patients with a history of treatment limiting toxicity to both pyrimethamine and sulfonamides will be assigned to receive atovaquone plus clarithromycin. Patients must have: - Documented HIV infection or diagnosis of AIDS (except for CD4 count < 200 cells/mm3). - Toxoplasmic encephalitis. - Ability to give informed consent or legal designee who could give consent. PER AMENDMENT 4/3/96: - NOTE - A history of treatment limiting toxicity to both pyrimethamine and sulfonamides will result in the patient being enrolled in the atovaquone plus clarithromycin arm. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: - Coma. - Opportunistic infection that requires either acute or maintenance treatment with disallowed medications. - Any infections or neoplasms of the central nervous system other than Toxoplasma, HIV encephalopathy, or syphilis. - Unable to take oral study drugs. - Malabsorption (i.e., three or more episodes of diarrhea per day that has caused >= 10 percent loss of body weight over the past 4 weeks). - Positive CSF or serum for Cryptococcus antigen or culture (a positive serum antigen only is acceptable, provided patient received prior antifungal therapy and is on maintenance, and the likelihood of recurrence is low). - Malignancy requiring use of cytotoxic chemotherapy. - Medical or social condition that would adversely affect study participation or compliance. Concurrent Medication: Excluded: - Trimethoprim-sulfamethoxazole. - Primaquine. - Sulfonamides. - Antifolates. - Dapsone. - Clarithromycin (except for patients in the cohort to receive this drug). - Azithromycin. - Clindamycin. - Other macrolides. - Gamma interferon. - Metoclopramide. - G-CSF or GM-CSF. Excluded in patients receiving clarithromycin as study drug: - Terfenadine, astemizole, or any other long-acting, non-sedating antihistamines. PER AMENDMENT 4/3/96: - Cisapride - may increase GI motility and may increase drug absorption. Patients with the following prior conditions are excluded: - History of treatment-limiting toxicity to atovaquone. - Receipt of > 96 hours (per amendment) of treatment prior to study entry for the current episode of toxoplasmic encephalitis.
Total Enrollment: 100

Location and Contact Information:

Overall Study Official:
LuftB,  Study Chair, 

Bronx Veterans Administration / Mount Sinai Hosp
Bronx,  New York,  10468
United States
 

Harlem Hosp Ctr
New York City,  New York,  10037
United States
 

Cook County Hosp
Chicago,  Illinois,  60612
United States
 

Univ of Cincinnati
Cincinnati,  Ohio,  452670405
United States
 

Hopital Bichat - Claude Bernard
Paris,  , 
France
 

Indiana Univ Hosp
Indianapolis,  Indiana,  462025250
United States
 

SUNY / Health Sciences Ctr at Brooklyn
Brooklyn,  New York,  112032098
United States
 

Bronx Municipal Hosp Ctr/Jacobi Med Ctr
Bronx,  New York,  10461
United States
 

Univ of Hawaii
Honolulu,  Hawaii,  96816
United States
 

Hopital Pasteur
Paris,  , 
France
 

Beth Israel Med Ctr
New York City,  New York,  10003
United States
 

Hopital Cochin - Port Royal
Paris,  , 
France
 

Univ of Miami School of Medicine
Miami,  Florida,  331361013
United States
 

St Louis Regional Hosp / St Louis Regional Med Ctr
St. Louis,  Missouri,  63112
United States
 

Ohio State Univ Hosp Clinic
Columbus,  Ohio,  432101228
United States
 

Univ of Southern California / LA County USC Med Ctr
Los Angeles,  California,  900331079
United States
 

Methodist Hosp of Indiana / Life Care Clinic
Indianapolis,  Indiana,  46202
United States
 

Northwestern Univ Med School
Chicago,  Illinois,  60611
United States
 

Hopital Saint Andre
Bordeaux,  , 
France
 

Jack Weiler Hosp / Bronx Municipal Hosp
Bronx,  New York,  10465
United States
 

Hosp Jean Verdier A Bondy
Bondy,  , 
France
 

Queens Med Ctr
Honolulu,  Hawaii,  96816
United States
 

SUNY / State Univ of New York
Syracuse,  New York,  13210
United States
 

Julio Arroyo
West Columbia,  South Carolina,  29169
United States
 

Hopital Hotel Dieu de Lyon
Lyon,  , 
France
 

SUNY / Erie County Med Ctr at Buffalo
Buffalo,  New York,  14215
United States
 

Bellevue Hosp / New York Univ Med Ctr
New York City,  New York,  10016
United States
 

Johns Hopkins Hosp
Baltimore,  Maryland,  21287
United States
 


Additional Information:
Study ID Numbers:
  ACTG 237;  ANRS 039
Study Start Date: 
Record last reviewed: January 1997
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00000794

Other Hiv Infections Studies:
1. A Pilot Study of 566C80 for the Salvage Treatment of Toxoplasmic Encephalitis in Patients Infected With the Human Immunodeficiency Virus (HIV) Who Have Failed or are Intolerant of Pyrimethamine-Sulfadiazine

2. A Randomized Prospective Study of Pyrimethamine Therapy for Prevention of Toxoplasmic Encephalitis in HIV-Infected Individuals With Serologic Evidence of Latent Toxoplasma gondii Infection

3. A Pilot Study of Oral Clindamycin and Pyrimethamine for the Treatment of Toxoplasmic Encephalitis in Patients With AIDS

4. Primary Prophylaxis of Cerebral Toxoplasmosis in HIV-Infected Patients

5. A Study of Azithromycin Plus Pyrimethamine in the Treatment of a Brain Infection in Patients with AIDS

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