NCT00000665

Brief Summary

To evaluate the relative effectiveness and safety of foscarnet versus ganciclovir for the treatment of cytomegalovirus (CMV) retinitis in people with AIDS; to evaluate the relative effect on survival of the use of these two anti-CMV agents in the treatment of CMV retinitis; to compare the relative benefits of immediate treatment with foscarnet or ganciclovir versus deferral of treatment for CMV retinitis limited to less than 25 percent of zones 2 and 3. CMV retinitis is a common opportunistic infection in patients with AIDS. Ganciclovir is currently the only drug approved for treatment of CMV retinitis in immunocompromised patients. Ganciclovir suppresses CMV infections, and relapse occurs in virtually all AIDS patients when ganciclovir is discontinued. Because of their similar hematologic (blood) toxicities, the simultaneous use of ganciclovir and zidovudine (AZT) is not recommended. More recently the drug foscarnet has become available for investigational use. Studies so far indicate that remission of CMV retinitis occurs in 36 to 77 percent of patients, and that relapse occurs in virtually all patients when the drug is discontinued. The relative effectiveness of foscarnet compared with ganciclovir for the immediate control of CMV infections is unknown. Further, the long-term effects of foscarnet or ganciclovir on CMV retinitis, survival, and morbidity are unknown. There is also no definitive information on the relative effectiveness and safety of deferred versus immediate treatment for CMV retinitis confined to zones 2 and 3.

Trial Health

80
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
240

participants targeted

Target at P75+ for not_applicable

Geographic Reach
1 country

9 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Primary Completion

Last participant's last visit for primary outcome

April 1, 1992

Completed
7.6 years until next milestone

First Submitted

Initial submission to the registry

November 2, 1999

Completed
1.8 years until next milestone

First Posted

Study publicly available on registry

August 31, 2001

Completed
Last Updated

March 14, 2011

Status Verified

December 1, 1994

First QC Date

November 2, 1999

Last Update Submit

March 11, 2011

Conditions

Keywords

RetinitisAIDS-Related Opportunistic InfectionsGanciclovirFoscarnetCytomegalovirus InfectionsAcquired Immunodeficiency SyndromeAntiviral Agents

Interventions

Eligibility Criteria

Age13 Years+
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Concurrent Medication:
  • Allowed:
  • Topical anti-Herpesvirus agents.
  • Zidovudine (AZT) for patients in deferral or foscarnet treatment groups:
  • mg every 4 hours. For patients on ganciclovir:
  • mg every 8 hours.
  • Dideoxyinosine (ddI) and other antiretroviral available via expanded access programs, investigational triazoles, granulocyte-macrophage colony-stimulating factor, and erythropoietin to treat marrow toxicity. The use of other investigational drugs will be considered on a drug by drug basis.
  • It is not recommended that patients receiving ganciclovir take AZT simultaneously. If AZT is prescribed for patients taking ganciclovir, it should be prescribed at reduced doses and discontinued if hematologic toxicity develops.
  • Patients must have:
  • Diagnosis of AIDS by CDC criteria or a documented HIV infection.
  • Cytomegalovirus (CMV) retinitis that does not require surgical intervention diagnosed in one or both eyes by a SOCA-certified ophthalmologist.
  • The means available for compliance with follow-up visits (including a caregiver if necessary).
  • Must consent to study or consent of parent or guardian if less than 18 years of age.
  • Willingness to take reduced dose of zidovudine (AZT) if dictated by treatment assignment.
  • Willingness to discontinue other systemic treatments for Herpesvirus infections while receiving foscarnet or ganciclovir.
  • +3 more criteria

You may not qualify if:

  • Co-existing Condition:
  • Patients with the following conditions or symptoms are excluded:
  • Sufficient media opacities to preclude fundus photographs in both eyes.
  • Concurrent Medication:
  • Excluded:
  • Other systemic treatments for Herpesvirus infections.
  • Other anti-cytomegalovirus therapy.
  • Excluded with foscarnet:
  • Parenteral pentamidine, amphotericin B, or aminoglycosides.
  • Use of marrow toxic agents with ganciclovir and nephrotoxic agents with foscarnet is discouraged, and alternative treatment should be used whenever possible.
  • Patients with the following are excluded:
  • Sufficient media opacities to preclude fundus photographs in both eyes.
  • Known or suspected allergy to one of the study medications.
  • Prior Medication:
  • Excluded:
  • +6 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (9)

UCSD - Shiley Eye Ctr / SOCA

La Jolla, California, 920930946, United States

Location

UCLA - Jules Stein Eye Institute / SOCA

Los Angeles, California, 900957003, United States

Location

UCSF - San Francisco Gen Hosp

San Francisco, California, 94143, United States

Location

Northwestern Univ / SOCA

Chicago, Illinois, 60611, United States

Location

Charity Hosp / Tulane Univ Med School

New Orleans, Louisiana, 70112, United States

Location

Johns Hopkins Hosp / SOCA

Baltimore, Maryland, 212879217, United States

Location

New York Univ Med Ctr / SOCA

New York, New York, 10016, United States

Location

New York Hosp - Cornell Med Ctr / Sloan - Kettering / SOCA

New York, New York, 10021, United States

Location

Mount Sinai Med Ctr / SOCA

New York, New York, 100296574, United States

Location

Related Publications (3)

  • Studies of ocular complications of AIDS Foscarnet-Ganciclovir Cytomegalovirus Retinitis Trial: 1. Rationale, design, and methods. AIDS Clinical Trials Group (ACTG). Control Clin Trials. 1992 Feb;13(1):22-39. doi: 10.1016/0197-2456(92)90027-w.

    PMID: 1315661BACKGROUND
  • Studies of Ocular Complications of AIDS Research Group; AIDS Clinical Trials Group. Mortality in patients with the acquired immunodeficiency syndrome treated with either foscarnet or ganciclovir for cytomegalovirus retinitis. N Engl J Med. 1992 Jan 23;326(4):213-20. doi: 10.1056/NEJM199201233260401.

    PMID: 1345799BACKGROUND
  • Holbrook JT, Jabs DA, Weinberg DV, Lewis RA, Davis MD, Friedberg D; Studies of Ocular Complications of AIDS (SOCA) Research Group. Visual loss in patients with cytomegalovirus retinitis and acquired immunodeficiency syndrome before widespread availability of highly active antiretroviral therapy. Arch Ophthalmol. 2003 Jan;121(1):99-107. doi: 10.1001/archopht.121.1.99.

    PMID: 12523893BACKGROUND

MeSH Terms

Conditions

Cytomegalovirus RetinitisHIV InfectionsRetinitisAIDS-Related Opportunistic InfectionsMultiple Acyl Coenzyme A Dehydrogenase DeficiencyCytomegalovirus InfectionsAcquired Immunodeficiency Syndrome

Interventions

FoscarnetGanciclovir

Condition Hierarchy (Ancestors)

Eye Infections, ViralEye InfectionsInfectionsHerpesviridae InfectionsDNA Virus InfectionsVirus DiseasesEye DiseasesRetinal DiseasesBlood-Borne InfectionsCommunicable DiseasesSexually Transmitted Diseases, ViralSexually Transmitted DiseasesLentivirus InfectionsRetroviridae InfectionsRNA Virus InfectionsGenital DiseasesUrogenital DiseasesImmunologic Deficiency SyndromesImmune System DiseasesOpportunistic InfectionsAmino Acid Metabolism, Inborn ErrorsMetabolism, Inborn ErrorsGenetic Diseases, InbornCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesMetabolic DiseasesNutritional and Metabolic DiseasesMitochondrial DiseasesSlow Virus Diseases

Intervention Hierarchy (Ancestors)

Phosphonoacetic AcidAcetatesAcids, AcyclicCarboxylic AcidsOrganic ChemicalsOrganophosphonatesOrganophosphorus CompoundsAcyclovirGuanineHypoxanthinesPurinonesPurinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic Compounds

Study Design

Study Type
interventional
Phase
not applicable
Purpose
TREATMENT
Sponsor Type
NIH

Study Record Dates

First Submitted

November 2, 1999

First Posted

August 31, 2001

Primary Completion

April 1, 1992

Last Updated

March 14, 2011

Record last verified: 1994-12

Locations