NCT00000727

Brief Summary

To determine if the drug combination sulfamethoxazole-trimethoprim (SMX-TMP), given by mouth, and the drug pentamidine (PEN), given by inhaled aerosol, are effective in preventing a relapse of Pneumocystis carinii pneumonia (PCP) when they are given to patients who have recovered from a first episode of PCP and are being given zidovudine (AZT) to treat primary HIV infection. AZT prolongs survival in patients with AIDS and decreases the occurrence of opportunistic infections such as PCP. However, PCP recurs in about 43 percent of patients receiving AZT, indicating a need for other treatments to reduce the relapse rate. The two medications to be tested in this study, SMX/TMP and aerosolized PEN, have also been partially effective in preventing recurrence of PCP. It is hoped that the combination of AZT with these medications will be more effective than AZT or one of the medications alone.

Trial Health

80
On Track

Trial Health Score

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

Enrollment
322

participants targeted

Target at P50-P75 for phase_3

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

Study Completion

Last participant's last visit for all outcomes

August 1, 1991

Completed
8.3 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

November 3, 2021

Status Verified

October 1, 2021

First QC Date

November 2, 1999

Last Update Submit

October 27, 2021

Conditions

Keywords

SulfadoxineTrimethoprim-Sulfamethoxazole CombinationAIDS-Related Opportunistic InfectionsPneumonia, Pneumocystis cariniiPentamidinePyrimethamineDrug EvaluationAdministration, InhalationAdministration, OralAerosolsAcquired Immunodeficiency SyndromeZidovudine

Interventions

Eligibility Criteria

Age12 Years+
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Patients must fulfill the following criteria:
  • Randomization within 10 weeks of completing therapy for Pneumocystis carinii pneumonia (PCP).
  • Ability to tolerate oral and aerosolized therapy at the time of randomization.
  • Life expectancy \> 4 months.
  • Concurrent Medication:
  • Allowed:
  • Inhaled bronchodilators for cough and bronchospasm related to aerosolized pentamidine treatment.
  • Aspirin at modest doses.
  • Ibuprofen at modest doses.
  • Acetaminophen at modest doses.
  • Erythropoietin for management of anemia.
  • Allowed to treat opportunistic infections while on study:
  • Acyclovir.
  • Ketoconazole.
  • Amphotericin B.
  • +14 more criteria

You may not qualify if:

  • Active drug or alcohol abuse which would impair performance as a study subject.
  • Concurrent Medication:
  • Excluded:
  • Famotidine.
  • Any medications suspected of interference with the metabolism of zidovudine.
  • Flurazepam.
  • Chronic probenecid.
  • Phenobarbital.
  • Phenytoin.
  • Experimental therapies, except as noted.
  • Chronic oral bronchodilators should not be started in patients in order to maintain them on aerosolized pentamidine after they have exhibited pulmonary toxicity.
  • Prior Medication:
  • Excluded for the 30 patients who will undergo pharmacokinetic studies:
  • Zidovudine (AZT) at any time.
  • Excluded within 7 days of study entry for the 30 patients who will undergo pharmacokinetic studies:
  • +15 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (9)

USC CRS

Los Angeles, California, 90033, United States

Location

Ucsd, Avrc Crs

San Diego, California, 92103, United States

Location

Ucsf Aids Crs

San Francisco, California, 94110, United States

Location

Indiana Univ. School of Medicine, Infectious Disease Research Clinic

Indianapolis, Indiana, 46202, United States

Location

Bmc Actg Crs

Boston, Massachusetts, 02118, United States

Location

University of Minnesota, ACTU

Minneapolis, Minnesota, 55455, United States

Location

Memorial Sloan-Kettering Cancer Ctr.

New York, New York, 10021, United States

Location

Case CRS

Cleveland, Ohio, 44106, United States

Location

University of Washington AIDS CRS

Seattle, Washington, 98105, United States

Location

Related Publications (4)

  • Freedberg KA, Hardy WD, Holzman RS, Tosteson AN, Craven DE. Validating literature-based models with direct clinical trial results: the cost-effectiveness of secondary prophylaxis for PCP in AIDS patients. Med Decis Making. 1996 Jan-Mar;16(1):29-35. doi: 10.1177/0272989X9601600110.

    PMID: 8717596BACKGROUND
  • Hardy WD, Feinberg J, Finkelstein DM, Power ME, He W, Kaczka C, Frame PT, Holmes M, Waskin H, Fass RJ, et al. A controlled trial of trimethoprim-sulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. AIDS Clinical Trials Group Protocol 021. N Engl J Med. 1992 Dec 24;327(26):1842-8. doi: 10.1056/NEJM199212243272604.

    PMID: 1448121BACKGROUND
  • Hardy WD, Holzman RS, Avramis V, Bawdon R, Fall H, Feinberg J. Clinical and pharmacokinetic interactions of combined zidovudine (ZDV) therapy and sulfadoxine-pyrimethamine (fansidar) prophylaxis in post-PCP AIDS patients (ACTG 021). Int Conf AIDS. 1989 Jun 4-9;5:294 (abstract no TBP46)

    BACKGROUND
  • Robins JM, Finkelstein DM. Correcting for noncompliance and dependent censoring in an AIDS Clinical Trial with inverse probability of censoring weighted (IPCW) log-rank tests. Biometrics. 2000 Sep;56(3):779-88. doi: 10.1111/j.0006-341x.2000.00779.x.

    PMID: 10985216BACKGROUND

MeSH Terms

Conditions

Pneumonia, PneumocystisHIV InfectionsAIDS-Related Opportunistic InfectionsRespiratory AspirationAcquired Immunodeficiency Syndrome

Interventions

PentamidinePyrimethamineTrimethoprim, Sulfamethoxazole Drug Combinationfanasil, pyrimethamine drug combinationZidovudine

Condition Hierarchy (Ancestors)

Lung Diseases, FungalMycosesBacterial Infections and MycosesInfectionsPneumocystis InfectionsRespiratory Tract InfectionsPneumoniaLung DiseasesRespiratory Tract DiseasesBlood-Borne InfectionsCommunicable DiseasesSexually Transmitted Diseases, ViralSexually Transmitted DiseasesLentivirus InfectionsRetroviridae InfectionsRNA Virus InfectionsVirus DiseasesGenital DiseasesUrogenital DiseasesImmunologic Deficiency SyndromesImmune System DiseasesOpportunistic InfectionsRespiration DisordersPathologic ProcessesPathological Conditions, Signs and SymptomsSlow Virus Diseases

Intervention Hierarchy (Ancestors)

BenzamidinesAmidinesOrganic ChemicalsPyrimidinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsSulfamethoxazoleBenzenesulfonamidesSulfonamidesAmidesSulfanilamidesAniline CompoundsAminesBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsSulfonesSulfur CompoundsTrimethoprimDrug CombinationsPharmaceutical PreparationsThymidinePyrimidine NucleosidesDideoxynucleosidesDeoxyribonucleosidesNucleosidesNucleic Acids, Nucleotides, and Nucleosides

Study Officials

  • Holzman R

    STUDY CHAIR
  • Hardy WD

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
phase 3
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
NIH
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 2, 1999

First Posted

August 31, 2001

Study Completion

August 1, 1991

Last Updated

November 3, 2021

Record last verified: 2021-10

Locations