Comparison of Two Dosage Regimens of Oral Dapsone for Prophylaxis of Pneumocystis Carinii Pneumonia in Pediatric HIV Infection
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Purpose
Primary: To compare the toxicity of daily versus weekly dapsone in HIV-infected infants and children; to study the pharmacokinetics of orally administered dapsone in HIV-infected infants and children.
Secondary: To obtain information on the rate of Pneumocystis carinii pneumonia ( PCP ) breakthrough in children receiving two different dose regimens of dapsone.
Prophylaxis for Pneumocystis carinii pneumonia ( PCP ) is recommended for all HIV-infected children considered to be at high risk. Approximately 15 percent of children are intolerant to trimethoprim / sulfamethoxazole, the first choice drug for PCP prophylaxis. Since many children are also unable to take or tolerate aerosolized pentamidine, dapsone is a second choice for PCP prophylaxis. The most favorable dose regimen for dapsone has not been established.
| Condition | Intervention | Phase |
|---|---|---|
|
Pneumonia, Pneumocystis Carinii HIV Infections |
Drug: Dapsone |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Pharmacokinetics Study Intervention Model: Parallel Assignment Primary Purpose: Treatment |
| Official Title: | Comparison of Two Dosage Regimens of Oral Dapsone for Prophylaxis of Pneumocystis Carinii Pneumonia in Pediatric HIV Infection |
| Estimated Enrollment: | 96 |
| Study Completion Date: | June 1998 |
Prophylaxis for Pneumocystis carinii pneumonia ( PCP ) is recommended for all HIV-infected children considered to be at high risk. Approximately 15 percent of children are intolerant to trimethoprim / sulfamethoxazole, the first choice drug for PCP prophylaxis. Since many children are also unable to take or tolerate aerosolized pentamidine, dapsone is a second choice for PCP prophylaxis. The most favorable dose regimen for dapsone has not been established.
Ninety-six HIV-infected infants and children who are intolerant to trimethoprim / sulfamethoxazole ( TMP / SMX ) are randomized to receive oral dapsone in a lower dose once daily or at a higher dose once weekly. Treatment continues until the last patient enrolled has received at least 3 months of therapy. Blood samples are drawn between weeks 4 and 8, at weeks 12 and 24, and every 3 months thereafter during dapsone administration.
Eligibility| Ages Eligible for Study: | 1 Month to 12 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria
Concurrent Medication:
Allowed:
- Rifampin and rifampin derivatives for up to 1 week during the study.
- Rifabutin or other drugs that could alter dapsone metabolism (if prescribed by the child's primary care physician).
Patients must have:
- Evidence of HIV infection.
PER AMENDMENT 11/16/95:
- Children who require prophylaxis. (Was written - Risk of developing PCP.)
- Known intolerance to TMP / SMX.
- Consent of parent or guardian. Patients entering this study may be co-enrolled in other ACTG pediatric studies.
Exclusion Criteria
Co-existing Condition:
Patients with the following symptoms and conditions are excluded:
- Glucose-6-phosphate dehydrogenase deficiency.
- Known allergy to dapsone.
Concurrent Medication:
Excluded:
- Rifampin, rifampin derivatives, or oxidant drugs for more than 1 week.
Patients with the following prior conditions are excluded:
- Serious or life-threatening reactions to TMP / SMX (e.g., anaphylaxis, Stevens-Johnson syndrome, hypotension) that would contraindicate therapy with sulfa drugs.
Prior Medication:
Excluded:
- Prior dapsone.
- Rifampin, rifampin derivatives, or oxidant drugs within 1 week prior to study entry.
- TMP / SMX within 7 days prior to study entry (and toxicity must be clearly resolving).
Prior Treatment:
Excluded:
- RBC transfusion within 4 weeks prior to study entry.
Contacts and Locations
Show 46 Study Locations| Study Chair: | McIntosh K | |
| Study Chair: | Cooper E |
More Information
Publications:
| Responsible Party: | National Institute of Allergy and Infectious Diseases (NIAID) |
| ClinicalTrials.gov Identifier: | NCT00000739 History of Changes |
| Other Study ID Numbers: | ACTG 179, 11154 |
| Study First Received: | November 2, 1999 |
| Last Updated: | March 30, 2012 |
| Health Authority: | Unspecified |
Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
|
Pneumonia, Pneumocystis carinii Dapsone Acquired Immunodeficiency Syndrome AIDS-Related Complex Drug Administration Schedule |
Additional relevant MeSH terms:
|
Pneumonia, Pneumocystis Pneumocystis Infections HIV Infections Acquired Immunodeficiency Syndrome Pneumonia Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases Slow Virus Diseases Lung Diseases |
Respiratory Tract Diseases Respiratory Tract Infections Lung Diseases, Fungal Mycoses Dapsone Antimalarials Antiprotozoal Agents Antiparasitic Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Folic Acid Antagonists Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Leprostatic Agents |
ClinicalTrials.gov processed this record on June 18, 2013