Amphotericin Alone or in Combination With Fluconazole for AIDS-Associated Meningitis

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:
NCT00145249
First received: September 2, 2005
Last updated: May 10, 2012
Last verified: October 2009
Results First Received: March 18, 2010  
Study Type: Interventional
Study Design: Allocation: Randomized;   Endpoint Classification: Safety/Efficacy Study;   Intervention Model: Parallel Assignment;   Masking: Open Label;   Primary Purpose: Treatment
Condition: Cryptococcal Meningitis
Interventions: Drug: Amphotericin B
Drug: Fluconazole

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
Subjects were screened and enrolled at 10 sites in the US and 5 sites in Thailand.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
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Reporting Groups
  Description
AmphoB Standard Amphotericin B 0.7 mg/kg for 14 day followed by fluconazole 400 mg daily for 8 weeks. For subjects in the standard therapy arm whose Amphotericin B dose is continued beyond 14 days, fluconazole initiation will be delayed.
AmphoB+Fluc400 Amphotericin B 0.7 mg/kg and the randomized dose of fluconazole at 400 mg/day for the first 14 days, then the randomized dose of fluconazole at 400 mg/day respectively for an additional 8 weeks.
AmphoB + Fluc800 Amphotericin B 0.7 mg/kg and the randomized dose of fluconazole at 800 mg/day for the first 14 days, then the randomized dose of fluconazole at 800 mg/day respectively for an additional 8 weeks.

Participant Flow:   Overall Study
    AmphoB Standard     AmphoB+Fluc400     AmphoB + Fluc800  
STARTED     47 [1]   48 [2]   48 [3]
COMPLETED     36     33     31  
NOT COMPLETED     11     15     17  
[1] 47 subjects randomized; 45 subjects treated
[2] 48 subjects randomized; 47 subjects treated-2 subjects randomized to AmphoB rec'd AmphoB+Fluc400
[3] 48 subjects randomized; 49 treated-3 subjects randomized to AmphoB+Fluc400 rec'd AmphoB+Fluc800



  Baseline Characteristics


  Outcome Measures
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1.  Primary:   Number of Grade 3-5 Adverse Experiences That Are Definitely or Probably Related to Study Drug   [ Time Frame: Day 100 ]

2.  Primary:   Number of Dose-limiting Toxicities Attributed to Treatment Regimens   [ Time Frame: Day 100 ]

3.  Secondary:   Number of Deaths   [ Time Frame: 14, 42, and 70 days ]

4.  Secondary:   Number of Subjects With Cerebrospinal Fluid (CSF) Culture Conversion at Multiple Time Points   [ Time Frame: Baseline, 14, 42, and 70 days ]

5.  Secondary:   Number of Subjects Meeting the Key Efficacy Endpoint of Treatment Success   [ Time Frame: 14, 42, and 70 days ]

6.  Secondary:   Number of Subjects Reporting Immune Reconstitution Inflammatory Syndrome (IRIS)   [ Time Frame: 14, 42, and 70 days ]

7.  Secondary:   Mean Days of Hospitalization   [ Time Frame: 7, 14, 42, and 70 days ]

8.  Secondary:   Number of Cryptococcal Isolates With Antifungal Susceptibility   [ Time Frame: Days 14 and 70 ]

9.  Secondary:   Mean Change in Neurological Exam Score From Baseline - Day 14   [ Time Frame: Baseline and Day 14 ]

10.  Secondary:   Mean Change in Neurological Exam Score From Baseline - Day 42   [ Time Frame: Baseline and Day 42 ]

11.  Secondary:   Mean Change in Neurological Exam Score From Baseline - Day 70   [ Time Frame: Baseline and Day 70 ]

12.  Secondary:   Mean Change in Neurological Exam Score From Baseline - Day 168   [ Time Frame: Baseline and Day 168 ]


  Serious Adverse Events


  Other Adverse Events


  Limitations and Caveats
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Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
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