Ferumoxytol-enhanced Imaging and Mapping in neuroAIDS

NCT ID: NCT02678767

Last Updated: 2017-10-27

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

PHASE2

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2017-09-30

Brief Summary

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This project will investigate the ability of a novel MRI contrast agent to identify and quantitate ongoing monocyte/macrophage (M/MΦ)-mediated inflammation in the brains of HIV-infected individuals.

Detailed Description

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HIV-associated neurocognitive disorders (HAND) continue to be prevalent despite effective combination antiretroviral therapy (cART) and have a significant impact on morbidity and quality of life. Monocytes/macrophages (M/MΦ) are believed to play a critical role in the pathogenesis of HAND. Neuroimaging HIV research has not focused on assessing M/MΦ-mediated inflammation in the brain. Currently, no neuroimaging modality exists that can define the extent of active inflammation due to M/MΦ in HAND either as a clinical diagnostic tool or to assist in defining objective improvement in clinical trials addressing HAND. Ferumoxytol is an ultra-small iron oxide MRI contrast agent avidly taken up by circulating M/MΦ. The investigators hypothesize that ferumoxytol-based imaging can identify ongoing inflammation due to perivascular M/MΦ which is believed to represent a key pathologic correlate of HAND.

Conditions

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AIDS Dementia Complex

Keywords

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HIV Dementia Neuroimaging

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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HIV+ with neurocognitive disorder

All subjects will receive neurocognitive testing. Subjects will have a brain MRI prior to drug infusion. A one-time ferumoxytol IV infusion will be given at a dose of 4mg Fe/kg up to a maximum of 510mg of elemental iron delivered at a rate of 1ml/sec. A second brain MRI will be completed post-infusion

Group Type EXPERIMENTAL

Ferumoxytol

Intervention Type DRUG

All subjects will receive neurocognitive testing. Subjects will have a brain MRI prior to drug infusion. A one-time ferumoxytol IV infusion will be given at a dose of 4mg Fe/kg up to a maximum of 510mg of elemental iron delivered at a rate of 1ml/sec. A second brain MRI will be completed post-infusion

HIV+ without neurocognitive impairment

All subjects will receive neurocognitive testing. Subjects will have a brain MRI prior to drug infusion. A one-time ferumoxytol IV infusion will be given at a dose of 4mg Fe/kg up to a maximum of 510mg of elemental iron delivered at a rate of 1ml/sec. A second brain MRI will be completed post-infusion

Group Type ACTIVE_COMPARATOR

Ferumoxytol

Intervention Type DRUG

All subjects will receive neurocognitive testing. Subjects will have a brain MRI prior to drug infusion. A one-time ferumoxytol IV infusion will be given at a dose of 4mg Fe/kg up to a maximum of 510mg of elemental iron delivered at a rate of 1ml/sec. A second brain MRI will be completed post-infusion

HIV- without neurocognitive impairment

All subjects will receive neurocognitive testing. Subjects will have a brain MRI prior to drug infusion. A one-time ferumoxytol IV infusion will be given at a dose of 4mg Fe/kg up to a maximum of 510mg of elemental iron delivered at a rate of 1ml/sec. A second brain MRI will be completed post-infusion

Group Type ACTIVE_COMPARATOR

Ferumoxytol

Intervention Type DRUG

All subjects will receive neurocognitive testing. Subjects will have a brain MRI prior to drug infusion. A one-time ferumoxytol IV infusion will be given at a dose of 4mg Fe/kg up to a maximum of 510mg of elemental iron delivered at a rate of 1ml/sec. A second brain MRI will be completed post-infusion

Interventions

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Ferumoxytol

All subjects will receive neurocognitive testing. Subjects will have a brain MRI prior to drug infusion. A one-time ferumoxytol IV infusion will be given at a dose of 4mg Fe/kg up to a maximum of 510mg of elemental iron delivered at a rate of 1ml/sec. A second brain MRI will be completed post-infusion

Intervention Type DRUG

Other Intervention Names

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Feraheme

Eligibility Criteria

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Inclusion Criteria

* Age 40-65 years
* Plasma HIV RNA \< 48 copies/ml (HIV+ subjects only)
* On stable cART \>= 1 year (HIV+ subjects only)
* Global neuropsychological (NP) score \<-0.5 in at least one cognitive domain known to be affected by HIV (neurocognitively impaired subjects only)
* Documentation of negative HIV infection by an FDA approved test (HIV- subjects only)

Exclusion Criteria

* Active substance use
* History of myocardial infarct or stroke
* Diabetes
* Chronic hepatitis C virus (HCV) infection
* Uncontrolled major affective disorder, active psychosis, central nervous system disease that affects the brain structure, or other uncontrolled chronic medical condition that in the opinion of the investigator may impact NP testing or the study outcome
* Psychoactive or other medications which may impact NP testing
* Factors that preclude MRI
* Known hypersensitivity to ferumoxytol
* History of laboratory measurements consistent with an iron overload syndrome
* Medical conditions that require frequent blood transfusions
* Taking oral iron supplements
* Elevated iron levels
* Any condition, which in the opinion of the investigator, would compromise the subject's ability to participate
* Multiple drug allergies that may pose a greater risk of anaphylaxis associated with ferumoxytol
* Pregnant, unwillingness to practice birth control, or breastfeeding
* Unable to give informed consent
Minimum Eligible Age

40 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Hawaii Pacific Health

OTHER

Sponsor Role collaborator

University of Hawaii

OTHER

Sponsor Role collaborator

National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role collaborator

Beau Nakamoto

OTHER

Sponsor Role lead

Responsible Party

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Beau Nakamoto

Assistant Professor of Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Beau Nakamoto, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Hawaii

Locations

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Hawaii Center for AIDS

Honolulu, Hawaii, United States

Site Status

Countries

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United States

Other Identifiers

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H032

Identifier Type: OTHER

Identifier Source: secondary_id

1R21NS087951-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2013-077

Identifier Type: -

Identifier Source: org_study_id