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A Comparison of Three Drug Combinations Containing Clarithromycin in the Treatment of Mycobacterium Avium Complex (MAC) Disease in Patients With AIDS

Phase 2
Completed
Conditions
Mycobacterium Avium-intracellulare Infection
HIV Infections
Registration Number
NCT00001058
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief Summary

To compare the efficacy and safety of clarithromycin combined with rifabutin, ethambutol, or both in the treatment of disseminated Mycobacterium avium Complex (MAC) disease in persons with AIDS, including individuals who have or have not received prior MAC prophylaxis.

It is believed that effective therapy for MAC disease in patients with AIDS requires combinations of two or more antimycobacterial agents in order to overcome drug resistance and the unfavorable influence of the profound immunosuppression associated with AIDS. Data suggest that clarithromycin may have substantial activity in two- or three-drug combination regimens with clofazimine, rifamycin derivatives, ethambutol, or the 4-quinolones.

Detailed Description

It is believed that effective therapy for MAC disease in patients with AIDS requires combinations of two or more antimycobacterial agents in order to overcome drug resistance and the unfavorable influence of the profound immunosuppression associated with AIDS. Data suggest that clarithromycin may have substantial activity in two- or three-drug combination regimens with clofazimine, rifamycin derivatives, ethambutol, or the 4-quinolones.

Patients are randomized to one of three treatment arms containing clarithromycin in combination with ethambutol, rifabutin, or both. Clarithromycin alone is taken on days 1 through 3 to determine tolerance and rifabutin and/or ethambutol is added on day 3. AS PER AMENDMENT 7/2/97: Patients may elect to add ritonavir or indinavir to their treatment regimen. Treatment continues daily for 48 weeks. In the absence of a dose-limiting toxicity, those patients who are determined to be complete or partial responders continue on the regimen to which they were originally assigned. Patients who have failed or relapsed on originally assigned MAC therapy, must have their therapy amended to receive clarithromycin and at least two other drugs not included in their originally assigned regimen. Patients are followed twice in the first week, then every 2 weeks for the first 2 months, then monthly for the next 4 months, and then every 2 months thereafter until the end of 12 months. PER AMENDMENT 10/10/96: NOTE: Any patient who develops a toxicity to rifabutin or ethambutol after week 12 or thereafter will be offered the option of being registered to a salvage regimen of 2 new drugs not previously received, plus clarithromycin to continue for the study duration.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
246
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (34)

Alabama Therapeutics CRS

🇺🇸

Birmingham, Alabama, United States

USC CRS

🇺🇸

Los Angeles, California, United States

UCLA CARE Center CRS

🇺🇸

Los Angeles, California, United States

Ucsd, Avrc Crs

🇺🇸

San Diego, California, United States

Ucsf Aids Crs

🇺🇸

San Francisco, California, United States

Harbor-UCLA Med. Ctr. CRS

🇺🇸

Torrance, California, United States

University of Colorado Hospital CRS

🇺🇸

Aurora, Colorado, United States

The Ponce de Leon Ctr. CRS

🇺🇸

Atlanta, Georgia, United States

Queens Med. Ctr.

🇺🇸

Honolulu, Hawaii, United States

Univ. of Hawaii at Manoa, Leahi Hosp.

🇺🇸

Honolulu, Hawaii, United States

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Alabama Therapeutics CRS
🇺🇸Birmingham, Alabama, United States

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