A Phase II, Double-Blind Trial of Recombinant Human Nerve Growth Factor for Treatment of HIV-Associated Sensory Neuropathy
NCT ID: NCT00000842
Last Updated: 2021-11-04
Study Results
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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COMPLETED
PHASE2
270 participants
INTERVENTIONAL
1999-02-28
Brief Summary
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Up to now, treatments for HIV-associated sensory neuropathy have been symptomatic, relying on pain-modifying agents or membrane-stabilizing drugs. Because nerve growth factor is important in the development and maintenance of sympathetic and sensory neurons and their outgrowths, it is proposed that recombinant human nerve growth factor may provide a specific restorative treatment for HIV-associated painful sensory neuropathy.
Detailed Description
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Patients are randomized to receive either rhNGF at one of two doses or placebo, administered subcutaneously twice weekly for 18 weeks. Patients are stratified into three groups within their regimens by use of didanosine, zalcitabine, or stavudine as follows: current use vs. discontinued between 8 and 26 weeks before randomization vs. never used or discontinued use at least 26 weeks before randomization. Patients will assess their pain daily using the Gracely Pain Scale. AS PER AMENDMENT 5/6/97: After completion of the double-blind phase (18 weeks on treatment followed by 4 weeks off treatment), patients may receive open-label, active drug treatment according to their previously assigned regimen for an additional 48 weeks.
Conditions
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Keywords
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Study Design
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TREATMENT
DOUBLE
Interventions
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Nerve Growth Factor, Recombinant Human
Eligibility Criteria
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Inclusion Criteria
Allowed:
* Maintenance treatment of CMV retinitis, MAI bacteremia, or cryptococcal meningitis is permitted.
* Local therapy for Kaposi's sarcoma.
Patients must have:
* Evidence of HIV antibodies documented by a licensed ELISA and a second, FDA-approved, confirmatory test.
* Diagnosis of HIV-associated, predominantly sensory neuropathy by a neurologist.
* Willingness and ability to complete the pain and medication log and competence to assess pain level throughout the study.
Prior Medication:
Allowed:
* History of stable-dose (defined as no more than 50% increase or decrease in dose) antiretroviral therapy for eight weeks before randomization, including the following:
* didanosine, zalcitabine, stavudine, lamivudine, protease inhibitors, and antiretrovirals available through expanded access trials.
* Chemotherapeutic drugs other than neurotoxic systemic chemotherapeutic agents within 30 days prior to randomization.
Exclusion Criteria
Patients with the following symptoms or conditions are excluded:
* Presence of acute, active, opportunistic infection, except oral thrush; oral, genital or rectal herpes; and MAI bacteremia within two weeks before randomization.
* Evidence of another contributing cause for peripheral neuropathy, including:
* diabetes mellitus, hereditary neuropathy, current vitamin B12 deficiency and no supplementation or supplementation \<= 3 months, or treatment with any drug that might contribute to sensory neuropathy.
* Major active psychiatric disorder (depression is allowed provided patient has received a stable antidepressant regimen for at least four weeks before randomization).
* Current active malignancy. NOTE: Malignancies in remission that do not require further treatment or Kaposi's sarcoma requiring only local treatment are allowed.
* Any conditions, including dementia and myelopathy, that would interfere with patient evaluation, accurate completion of the symptom scale, or compliance with subcutaneous injection.
Concurrent Medication:
Excluded:
* Chemotherapeutic agents.
* Systemic corticosteroids or immunomodulators.
* Initiation of new antiretroviral to a stable regimen.
Prior Medication:
Excluded:
* Neurotoxic systemic chemotherapy within the past 90 days.
* Systemic corticosteroids or immunomodulators within the past 30 days.
* Initiation of non-opioid prescription medication for pain during the 2 weeks preceding randomization (including tricyclic antidepressants, mexiletine, phenytoin, and carbamazepine).
* Treatment for acute opportunistic infections within the past 14 days (maintenance therapy for CMV retinitis, MAI bacteremia, or cryptococcal meningitis is permitted).
Active drug or alcohol abuse that would affect study compliance.
18 Years
70 Years
ALL
No
Sponsors
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National Institute of Allergy and Infectious Diseases (NIAID)
NIH
Responsible Party
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Principal Investigators
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McArthur J
Role: STUDY_CHAIR
Simpson D
Role: STUDY_CHAIR
Schifitto G
Role: STUDY_CHAIR
Locations
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UCLA CARE Center CRS
Los Angeles, California, United States
San Mateo County AIDS Program
San Mateo, California, United States
Stanford CRS
Stanford, California, United States
Northwestern University CRS
Chicago, Illinois, United States
Johns Hopkins Adult AIDS CRS
Baltimore, Maryland, United States
Beth Israel Deaconess - East Campus A0102 CRS
Boston, Massachusetts, United States
Washington U CRS
St Louis, Missouri, United States
NY Univ. HIV/AIDS CRS
New York, New York, United States
Cornell University A2201
New York, New York, United States
Univ. of Rochester ACTG CRS
Rochester, New York, United States
Unc Aids Crs
Chapel Hill, North Carolina, United States
Case CRS
Cleveland, Ohio, United States
The Ohio State Univ. AIDS CRS
Columbus, Ohio, United States
University of Washington AIDS CRS
Seattle, Washington, United States
Countries
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References
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Nerve growth factor study opens. GMHC Treat Issues. 1996 Nov;10(11):9.
Gilden D. Hyperthermia study finds little effect. GMHC Treat Issues. 1995 Nov;9(11):5-7.
James JS. Nerve growth factor: major trial canceled, revived after protest. AIDS Treat News. 1995 Apr 21;(no 221):5.
Simpson DM, Haidich AB, Schifitto G, Yiannoutsos CT, Geraci AP, McArthur JC, Katzenstein DA; ACTG 291 study team. Severity of HIV-associated neuropathy is associated with plasma HIV-1 RNA levels. AIDS. 2002 Feb 15;16(3):407-12. doi: 10.1097/00002030-200202150-00012.
Lein B. Potential therapy for painful neuropathy. PI Perspect. 1995 May;(no 16):11.
McArthur JC, Yiannoutsos C, Simpson DM, Adornato BT, Singer EJ, Hollander H, Marra C, Rubin M, Cohen BA, Tucker T, Navia BA, Schifitto G, Katzenstein D, Rask C, Zaborski L, Smith ME, Shriver S, Millar L, Clifford DB, Karalnik IJ. A phase II trial of nerve growth factor for sensory neuropathy associated with HIV infection. AIDS Clinical Trials Group Team 291. Neurology. 2000 Mar 14;54(5):1080-8. doi: 10.1212/wnl.54.5.1080.
Other Identifiers
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11267
Identifier Type: REGISTRY
Identifier Source: secondary_id
ACTG 291
Identifier Type: -
Identifier Source: org_study_id