Effectiveness of Palifermin in Increasing CD4 Counts in Treatment-Experienced HIV Infected Adults

NCT ID: NCT00376935

Last Updated: 2021-11-04

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

99 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-12-31

Study Completion Date

2008-09-30

Brief Summary

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Palifermin is a modified version of a naturally occurring human growth factor that is currently approved by the FDA to treat blood cancers. The purpose of this study is to determine whether palifermin can increase CD4 counts in treatment-experienced HIV infected adults.

Detailed Description

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Antiretroviral therapy (ART) has dramatically improved the clinical outcome for HIV infected adults; however, some people on potent ART experience poor recovery of CD4 counts despite maximum suppression of viral load. Such uncontrolled HIV infection is associated with the reduced ability by the human body to create new T cells (or thymopoiesis). HIV infected adults experiencing reduced thymopoiesis are at increased risk of clinical disease progression.

The thymus is the primary site for CD4 cell development; research suggests that keratinocyte growth factor (KGF) may enhance thymus activity in individuals who exhibit reduced thymopoiesis. Palifermin is a modified version of the naturally occurring KGF that is approved to treat people with hematologic malignancies. The purpose of this study is to evaluate the safety and efficacy of palifermin in increasing CD4 counts, through enhanced thymopoiesis, in treatment-experienced HIV infected adults with suppressed viral loads but low CD4 counts.

This study will last 24 weeks. Participants will be randomly assigned to one of four arms:

* Arm A participants will receive placebo
* Arm B participants will receive palifermin 20 mcg/kg
* Arm C participants will receive palifermin 40 mcg/kg
* Arm D participants will receive palifermin 60 mcg/kg

Participants will receive intravenous doses of their assigned intervention on Days 1, 2, and 3. All participants must remain on their current ART regimen for the duration of the study. ART will not be provided by the study. There will be six study visits, and they will occur at Weeks 1, 2, 4, 8, 12, and 24. All visits will include a targeted physical exam and blood and urine collection.

Conditions

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HIV Infections

Keywords

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Treatment Experienced

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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1

Participants will receive palifermin placebo injection on Days 1, 2, and 3

Group Type PLACEBO_COMPARATOR

Palifermin placebo

Intervention Type DRUG

Keratinocyte growth factor placebo administered via injection

2

Participants will receive palifermin 20 mcg/kg injection on Days 1, 2, and 3

Group Type EXPERIMENTAL

Palifermin

Intervention Type DRUG

Keratinocyte growth factor administered via injection

3

Participants will receive palifermin 40 mcg/kg injection on Days 1, 2, and 3

Group Type EXPERIMENTAL

Palifermin

Intervention Type DRUG

Keratinocyte growth factor administered via injection

4

Participants will receive palifermin 60 mcg/kg injection on Days 1, 2, and 3

Group Type EXPERIMENTAL

Palifermin

Intervention Type DRUG

Keratinocyte growth factor administered via injection

Interventions

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Palifermin

Keratinocyte growth factor administered via injection

Intervention Type DRUG

Palifermin placebo

Keratinocyte growth factor placebo administered via injection

Intervention Type DRUG

Other Intervention Names

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rHuKGF rHuKGF placebo

Eligibility Criteria

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Inclusion Criteria

* HIV infected
* Receiving potent ART, defined as a combination of three or more antiretroviral drugs for at least 6 months prior to study entry
* CD4 count of 200 cells/mm3 or less within 30 days prior to study entry
* Documented CD4 count obtained at study screening
* Documented current, persistent viral load less than or equal to 200 copies/ml for at least 6 months prior to study entry
* Willing to use acceptable forms of contraception for the duration of the study

Exclusion Criteria

* Active pancreatitis
* Androgens, Immunomodulators (e.g., growth factors, systemic corticosteroids, HIV vaccines, immune globulin, interleukins, interferons), or investigational ART within 30 days prior to study entry
* Systemic cancer chemotherapy within 30 days prior to study entry, or history of radiation therapy to the neck and chest regions at any time.
* Allergy or sensitivity to any component of palifermin
* Prior treatment with palifermin or other keratinocyte growth factors
* Current drug or alcohol use that, in the opinion of the investigator, may interfere with study participation
* Serious illness or recent surgery that requires systemic treatment or hospitalization. Participants who have completed therapy or are clinically stable on therapy for at least 30 days prior to study entry are not excluded.
* Active cancer
* HIV-1 RNA levels \>200 copies/mL within 6 months prior to study entry
* Pregnant or breastfeeding
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections

NETWORK

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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Jeffrey M. Jacobson, MD

Role: STUDY_CHAIR

Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine

Locations

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USC CRS

Los Angeles, California, United States

Site Status

UCLA CARE Center CRS

Los Angeles, California, United States

Site Status

Stanford CRS

Palo Alto, California, United States

Site Status

Ucsd, Avrc Crs

San Diego, California, United States

Site Status

Harbor-UCLA Med. Ctr. CRS

Torrance, California, United States

Site Status

Univ. of Miami AIDS CRS

Miami, Florida, United States

Site Status

The Ponce de Leon Ctr. CRS

Atlanta, Georgia, United States

Site Status

IHV Baltimore Treatment CRS

Baltimore, Maryland, United States

Site Status

Bmc Actg Crs

Boston, Massachusetts, United States

Site Status

Washington U CRS

St Louis, Missouri, United States

Site Status

NY Univ. HIV/AIDS CRS

New York, New York, United States

Site Status

Columbia P&S CRS

New York, New York, United States

Site Status

Trillium Health ACTG CRS

Rochester, New York, United States

Site Status

Univ. of Rochester ACTG CRS

Rochester, New York, United States

Site Status

Unc Aids Crs

Chapel Hill, North Carolina, United States

Site Status

Duke Univ. Med. Ctr. Adult CRS

Durham, North Carolina, United States

Site Status

Case CRS

Cleveland, Ohio, United States

Site Status

MetroHealth CRS

Cleveland, Ohio, United States

Site Status

The Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

Hosp. of the Univ. of Pennsylvania CRS

Philadelphia, Pennsylvania, United States

Site Status

Vanderbilt Therapeutics CRS

Nashville, Tennessee, United States

Site Status

University of Washington AIDS CRS

Seattle, Washington, United States

Site Status

Countries

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Puerto Rico United States

References

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Aiuti F, Mezzaroma I. Failure to reconstitute CD4+ T-cells despite suppression of HIV replication under HAART. AIDS Rev. 2006 Apr-Jun;8(2):88-97.

Reference Type BACKGROUND
PMID: 16848276 (View on PubMed)

Franco JM, Rubio A, Martinez-Moya M, Leal M, Merchante E, Sanchez-Quijano A, Lissen E. T-cell repopulation and thymic volume in HIV-1-infected adult patients after highly active antiretroviral therapy. Blood. 2002 May 15;99(10):3702-6. doi: 10.1182/blood.v99.10.3702.

Reference Type BACKGROUND
PMID: 11986226 (View on PubMed)

van den Brink MR, Alpdogan O, Boyd RL. Strategies to enhance T-cell reconstitution in immunocompromised patients. Nat Rev Immunol. 2004 Nov;4(11):856-67. doi: 10.1038/nri1484.

Reference Type BACKGROUND
PMID: 15516965 (View on PubMed)

Ye P, Kourtis AP, Kirschner DE. Reconstitution of thymic function in HIV-1 patients treated with highly active antiretroviral therapy. Clin Immunol. 2003 Feb;106(2):95-105. doi: 10.1016/s1521-6616(02)00024-4.

Reference Type BACKGROUND
PMID: 12672400 (View on PubMed)

Other Identifiers

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10147

Identifier Type: REGISTRY

Identifier Source: secondary_id

ACTG A5212

Identifier Type: -

Identifier Source: secondary_id

A5212

Identifier Type: -

Identifier Source: org_study_id