HIV Infections Clinical Trial
Official title:
Studies of the Ocular Complications of AIDS (SOCA)--HPMPC Peripheral CMV Retinitis Trial (HPCRT)
To test and evaluate the efficacy and safety of intravenous cidofovir (Vistide, previously known as HPMPC) for the treatment of retinitis.
CMV (cytomegalovirus) retinitis is the most common intraocular infection in patients with
AIDS and is estimated to affect 35 percent to 40 percent of patients with AIDS. Untreated
CMV (cytomegalovirus) retinitis is a progressive disorder, the end result of which is total
retinal destruction and blindness. As of September 1997, drugs approved by the United States
Food and Drug Administration (FDA) for the treatment of CMV (cytomegalovirus)retinitis were
ganciclovir (Cytovene), foscarnet (Foscavir), and cidofovir (Vistide). Cidofovir has a
prolonged duration of effect permitting intermittent administration. All systemically
administered anti-CMV drugs are given in a similar fashion consisting of initial 2-week
high-dose treatment (induction) to control the infection followed by long-term lower dose
treatment (maintenance) to prevent relapse. Cidofovir is administered as an intravenous
infusion once weekly for induction therapy and once every 2 weeks as maintenance therapy.
The HPCRT evaluated the efficacy and safety of cidofovir therapy.
The HPCRT was a multicenter, randomized, controlled clinical trial of cidofovir for the
treatment of CMV (cytomegalovirus) retinitis. Patients with small peripheral CMV
(cytomegalovirus) retinitis lesions (i.e., not at risk of immediate loss of visual acuity)
were randomized to immediate treatment with cidofovir or deferred therapy until the
retinitis had progressed. Patients randomized to immediate therapy received either 1)
low-dose cidofovir at 5 mg/kg once weekly induction for 2 weeks, followed by 3 mg/kg once
every 2 weeks for maintenance or 2) high-dose cidofovir at 5 mg/kg once weekly induction for
2 weeks followed by 5 mg/kg once every 2 weeks for maintenance. Patients whose retinitis
progressed were given treatment according to best medical judgement, and those assigned to
deferral were generally treated with cidofovir.
Outcomes in this trial included retinitis progression, loss of retinal area, and morbidity.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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