Comparison of Two Dosage Regimens of Oral Dapsone for Prophylaxis of Pneumocystis Carinii Pneumonia in Pediatric HIV Infection

NCT ID: NCT00000739

Last Updated: 2021-11-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

96 participants

Study Classification

INTERVENTIONAL

Study Completion Date

1998-06-30

Brief Summary

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Primary: To compare the toxicity of daily versus weekly dapsone in HIV-infected infants and children; to study the pharmacokinetics of orally administered dapsone in HIV-infected infants and children.

Secondary: To obtain information on the rate of Pneumocystis carinii pneumonia ( PCP ) breakthrough in children receiving two different dose regimens of dapsone.

Prophylaxis for Pneumocystis carinii pneumonia ( PCP ) is recommended for all HIV-infected children considered to be at high risk. Approximately 15 percent of children are intolerant to trimethoprim / sulfamethoxazole, the first choice drug for PCP prophylaxis. Since many children are also unable to take or tolerate aerosolized pentamidine, dapsone is a second choice for PCP prophylaxis. The most favorable dose regimen for dapsone has not been established.

Detailed Description

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Prophylaxis for Pneumocystis carinii pneumonia ( PCP ) is recommended for all HIV-infected children considered to be at high risk. Approximately 15 percent of children are intolerant to trimethoprim / sulfamethoxazole, the first choice drug for PCP prophylaxis. Since many children are also unable to take or tolerate aerosolized pentamidine, dapsone is a second choice for PCP prophylaxis. The most favorable dose regimen for dapsone has not been established.

Ninety-six HIV-infected infants and children who are intolerant to trimethoprim / sulfamethoxazole ( TMP / SMX ) are randomized to receive oral dapsone in a lower dose once daily or at a higher dose once weekly. Treatment continues until the last patient enrolled has received at least 3 months of therapy. Blood samples are drawn between weeks 4 and 8, at weeks 12 and 24, and every 3 months thereafter during dapsone administration.

Conditions

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Pneumonia, Pneumocystis Carinii HIV Infections

Keywords

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Pneumonia, Pneumocystis carinii Dapsone Acquired Immunodeficiency Syndrome AIDS-Related Complex Drug Administration Schedule

Study Design

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Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Interventions

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Dapsone

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Concurrent Medication:

Allowed:

* Rifampin and rifampin derivatives for up to 1 week during the study.
* Rifabutin or other drugs that could alter dapsone metabolism (if prescribed by the child's primary care physician).

Patients must have:

* Evidence of HIV infection.

PER AMENDMENT 11/16/95:

* Children who require prophylaxis. (Was written - Risk of developing PCP.)
* Known intolerance to TMP / SMX.
* Consent of parent or guardian. Patients entering this study may be co-enrolled in other ACTG pediatric studies.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms and conditions are excluded:

* Glucose-6-phosphate dehydrogenase deficiency.
* Known allergy to dapsone.

Concurrent Medication:

Excluded:

* Rifampin, rifampin derivatives, or oxidant drugs for more than 1 week.

Patients with the following prior conditions are excluded:

* Serious or life-threatening reactions to TMP / SMX (e.g., anaphylaxis, Stevens-Johnson syndrome, hypotension) that would contraindicate therapy with sulfa drugs.

Prior Medication:

Excluded:

* Prior dapsone.
* Rifampin, rifampin derivatives, or oxidant drugs within 1 week prior to study entry.
* TMP / SMX within 7 days prior to study entry (and toxicity must be clearly resolving).

Prior Treatment:

Excluded:

* RBC transfusion within 4 weeks prior to study entry.
Minimum Eligible Age

1 Month

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jacobus Pharmaceutical

INDUSTRY

Sponsor Role collaborator

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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McIntosh K

Role: STUDY_CHAIR

Cooper E

Role: STUDY_CHAIR

Locations

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Long Beach Memorial Med. Ctr., Miller Children's Hosp.

Long Beach, California, United States

Site Status

Usc La Nichd Crs

Los Angeles, California, United States

Site Status

UCLA-Los Angeles/Brazil AIDS Consortium (LABAC) CRS

Los Angeles, California, United States

Site Status

Children's Hosp. & Research Ctr. Oakland, Ped. Clinical Research Ctr. & Research Lab.

Oakland, California, United States

Site Status

UCSD Maternal, Child, and Adolescent HIV CRS

San Diego, California, United States

Site Status

Harbor - UCLA Med. Ctr. - Dept. of Peds., Div. of Infectious Diseases

Torrance, California, United States

Site Status

Univ. of Colorado Denver NICHD CRS

Aurora, Colorado, United States

Site Status

Children's National Med. Ctr., ACTU

Washington D.C., District of Columbia, United States

Site Status

Howard Univ. Washington DC NICHD CRS

Washington D.C., District of Columbia, United States

Site Status

Univ. of Florida Jacksonville NICHD CRS

Jacksonville, Florida, United States

Site Status

Univ. of Miami Ped. Perinatal HIV/AIDS CRS

Miami, Florida, United States

Site Status

Emory Univ. School of Medicine, Dept. of Peds., Div. of Infectious Diseases

Atlanta, Georgia, United States

Site Status

Cook County Hosp.

Chicago, Illinois, United States

Site Status

Chicago Children's CRS

Chicago, Illinois, United States

Site Status

Univ. of Chicago - Dept. of Peds., Div. of Infectious Disease

Chicago, Illinois, United States

Site Status

Univ. of Illinois College of Medicine at Chicago, Dept. of Peds

Chicago, Illinois, United States

Site Status

Tulane/LSU Maternal/Child CRS

New Orleans, Louisiana, United States

Site Status

HMS - Children's Hosp. Boston, Div. of Infectious Diseases

Boston, Massachusetts, United States

Site Status

BMC, Div. of Ped Infectious Diseases

Boston, Massachusetts, United States

Site Status

Baystate Health, Baystate Med. Ctr.

Springfield, Massachusetts, United States

Site Status

WNE Maternal Pediatric Adolescent AIDS CRS

Worcester, Massachusetts, United States

Site Status

Children's Hospital of Michigan NICHD CRS

Detroit, Michigan, United States

Site Status

UMDNJ - Robert Wood Johnson

New Brunswick, New Jersey, United States

Site Status

St. Joseph's Hosp. & Med. Ctr. of New Jersey

Paterson, New Jersey, United States

Site Status

SUNY Downstate Med. Ctr., Children's Hosp. at Downstate NICHD CRS

Brooklyn, New York, United States

Site Status

North Shore-Long Island Jewish Health System, Dept. of Peds.

Great Neck, New York, United States

Site Status

Schneider Children's Hosp., Div. of Infectious Diseases

New Hyde Park, New York, United States

Site Status

NYU Med. Ctr., Dept. of Medicine

New York, New York, United States

Site Status

Columbia IMPAACT CRS

New York, New York, United States

Site Status

Incarnation Children's Ctr.

New York, New York, United States

Site Status

Harlem Hosp. Ctr. NY NICHD CRS

New York, New York, United States

Site Status

Univ. of Rochester ACTG CRS

Rochester, New York, United States

Site Status

Strong Memorial Hospital Rochester NY NICHD CRS

Rochester, New York, United States

Site Status

SUNY Stony Brook NICHD CRS

Stony Brook, New York, United States

Site Status

SUNY Upstate Med. Univ., Dept. of Peds.

Syracuse, New York, United States

Site Status

DUMC Ped. CRS

Durham, North Carolina, United States

Site Status

Case CRS

Cleveland, Ohio, United States

Site Status

The Children's Hosp. of Philadelphia IMPAACT CRS

Philadelphia, Pennsylvania, United States

Site Status

St. Christopher's Hosp. for Children

Philadelphia, Pennsylvania, United States

Site Status

Med. Univ. of South Carolina, Div. of Ped. Infectious Diseases

Charleston, South Carolina, United States

Site Status

St. Jude/UTHSC CRS

Memphis, Tennessee, United States

Site Status

Childrens Hosp. of the Kings Daughters

Norfolk, Virginia, United States

Site Status

UW School of Medicine - CHRMC

Seattle, Washington, United States

Site Status

Univ. Hosp. Ramón Ruiz Arnau, Dept. of Peds

Bayamón, , Puerto Rico

Site Status

San Juan City Hosp. PR NICHD CRS

San Juan, , Puerto Rico

Site Status

Univ. of Puerto Rico Ped. HIV/AIDS Research Program CRS

San Juan, , Puerto Rico

Site Status

Countries

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United States Puerto Rico

References

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Mirochnick M, Cooper E, McIntosh K. Pharmacokinetics of daily and weekly dapsone in HIV-infected children. Conf Retroviruses Opportunistic Infect. 1996 Jan 28-Feb 1;3rd:159

Reference Type BACKGROUND

Mirochnick M, Cooper E, Mcintosh K. Pharmacokinetics of daily and weekly dapsone in HIV-infected children. ACTG Protocol 179 Team. American Pediatric Association and Society for Pediatric Research annual meeting; 1996 May 6-10; Washington, D.C. Pediatr AIDS HIV Infect. 1996 Aug;7(4):280 (unnumbered abstract)

Reference Type BACKGROUND

Perrier M, Schwarz T, Gonzalez O, Brounts S. Squamous cell carcinoma invading the right temporomandibular joint in a Belgian mare. Can Vet J. 2010 Aug;51(8):885-7.

Reference Type BACKGROUND
PMID: 21037891 (View on PubMed)

McIntosh K, Cooper E, Xu J, Mirochnick M, Lindsey J, Jacobus D, Mofenson L, Yogev R, Spector SA, Sullivan JL, Sacks H, Kovacs A, Nachman S, Sleasman J, Bonagura V, McNamara J. Toxicity and efficacy of daily vs. weekly dapsone for prevention of Pneumocystis carinii pneumonia in children infected with human immunodeficiency virus. ACTG 179 Study Team. AIDS Clinical Trials Group. Pediatr Infect Dis J. 1999 May;18(5):432-9. doi: 10.1097/00006454-199905000-00007.

Reference Type BACKGROUND
PMID: 10353516 (View on PubMed)

Other Identifiers

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11154

Identifier Type: REGISTRY

Identifier Source: secondary_id

ACTG 179

Identifier Type: -

Identifier Source: org_study_id