Cidofovir Instillation in Hematopoietic Stem Cell Transplant (HSCT) Recipients With Hemorrhagic Cystitis

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00956176
Recruitment Status : Withdrawn
First Posted : August 11, 2009
Last Update Posted : September 7, 2012
Gilead Sciences
Information provided by (Responsible Party):
M.D. Anderson Cancer Center

Brief Summary:

The goal of this clinical research study is to learn how the body absorbs and processes 1 dose of cidofovir that is given directly into the bladder, in patients with a viral infection that is causing bleeding from the bladder.

The safety of this drug dose and the investigational way it is given (directly into the bladder) will also be studied.

Condition or disease Intervention/treatment Phase
Cystitis Bladder Diseases Drug: Cidofovir Not Applicable

  Hide Detailed Description

Detailed Description:

The Study Drug:

Cidofovir is designed to fight CMV (a viral infection) by blocking the CMV cells from dividing.

Cidofovir is commonly given by injection. For research purposes, in this study it will be given directly into the bladder through a foley catheter. This is one of the first studies where cidofovir is being given this way in humans.

Study Drug Administration:

If you are found to be eligible to take part in this study, on Day 1, Cidofovir will be put into your bladder through your foley catheter. The catheter will be clamped for 2 hours to keep the drug in your bladder. After 2 hours, the catheter will be unclamped. If you were receiving bladder irrigation as therapy for your hemorrhagic cystitis, this will be restarted.

Study Tests on Day 1:

On the day you receive cidofovir, blood (about 2 teaspoons) will be drawn 6 times. The first blood draw will occur before the cidofovir dose, and the last blood draw will occur 24 hours (+/- 1 hour) after the start of the dose. This blood will be used for pharmacokinetic (PK) and pharmacodynamic (PD) testing. PK testing measures the amount of study drug in the body at different time points. PD testing is used to look at how the level of study drug in your body may affect the disease.

Viral Load Testing:

During this study, extra urine and leftover blood to be collected and used for research to test for certain viruses. These viruses include the type of infection you had when joining this study, as well as cytomegalovirus (CMV) and another type of herpes virus.

The urine samples will be collected before the cidofovir dose on Day 1, after the cidofovir dose on Day 1, and again on Day 4.

Any blood left over from Day 1 testing will also be used for viral load testing.

It is possible that these urine and/or blood samples will be sent to an outside lab to perform this testing. If that occurs, your name and any personal identifying information will be coded before the samples are sent. Coding the samples is designed to protect your privacy.

Follow-Up Tests:

Blood (about 2 teaspoons) will be drawn for routine tests 2 times during the week after your cidofovir dose.

On Day 7 (+/- 2 days), you will be checked for any side effects that could be related to the study drug.

In addition, on Day 14 (+/- 2 days), blood samples will be drawn for PK testing, urine will be collected for routine tests, and your safety data will be recorded.

One final follow-up visit will take place on Day 30 (+/- 2 days). During this visit, the study staff will record any serious side effects you may be experiencing.

Length of Study Participation:

Your active study participation will be over after the Day 7 follow-up visit (+/- 2 days). If you experienced a side effect, however, the study staff will continue checking your medical records until the side effect becomes stable or gets better.

This is an investigational study. Cidofovir given by injection is commercially available and FDA approved to treat CMV in patients with HIV. It is investigational to give cidofovir directly into the bladder of patients who have a viral infection causing bleeding in the bladder.

Up to 6 patients will take part in this study. All will be enrolled at M. D. Anderson.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Intravesical Cidofovir Instillation in HSCT Recipients With Hemorrhagic Cystitis: A Single Dose Pharmacokinetic Study
Study Start Date : September 2012
Estimated Primary Completion Date : September 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Bladder Diseases
Drug Information available for: Cidofovir
U.S. FDA Resources

Arm Intervention/treatment
Experimental: Cidofovir Drug: Cidofovir
Single dose of 5 mg/kg administered in 100 ml of normal saline solution through a foley catheter to bladder. The catheter will be clamped for 2 hours to keep the drug in bladder.
Other Name: Vistide

Primary Outcome Measures :
  1. Systemic Absorption of Cidofovir via bladder instillation [ Time Frame: Blood collected pre-instillation, 1 hour, 2 hours, 4 hours and 14 hours after instillation. ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Polyoma BK or adenovirus viruria has been established either by positive urine cytology or by PCR for BK virus or by positive urine and/or blood culture for adenovirus
  2. The patient has either gross hematuria and/or passes blood clots
  3. Signed informed consent form
  4. Hospitalized patients with a Foley catheter
  5. Women of childbearing potential must agree to use 2 acceptable methods of birth control (e. g., abstinence, IUD, or barrier method), during the study period and one for a period of 2 months afterward. At least one of the methods must be a barrier method. Males must also agree to use acceptable method of birth control (barrier method) during the study period and for 2 months afterward.

Exclusion Criteria:

  1. Serum creatinine >1.5 mg/dl and/or calculated creatinine clearance < 55 ml/min using the Cockcroft-Gault Creatinine Clearance formula (CrCl). CrCl = {(140-Age) x Weight (kgs) x 0.85 (if female)}/ {72x Serum Creatinine (mg/dl)}
  2. Urine protein > 100 mg/dl (equivalent to > 2+ proteinuria)
  3. Age less than 18 years
  4. Prior therapy with formalin or carboprost 1 mg % administered intravesically
  5. Hypersensitivity to cidofovir, probenecid or sulfa-containing medications
  6. Have received prior cidofovir therapy within 2 weeks.
  7. Prior enrollment in the study
  8. Women who are pregnant or breast-feeding
  9. Evidence of end-organ adenoviral infection

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00956176

Sponsors and Collaborators
M.D. Anderson Cancer Center
Gilead Sciences
Principal Investigator: Roy F. Chemaly, MD, MPH, MBA UT MD Anderson Cancer Center

Additional Information:
Responsible Party: M.D. Anderson Cancer Center Identifier: NCT00956176     History of Changes
Other Study ID Numbers: 2007-0040
First Posted: August 11, 2009    Key Record Dates
Last Update Posted: September 7, 2012
Last Verified: September 2012

Keywords provided by M.D. Anderson Cancer Center:
BK virus infections
Hemorrhagic Cystitis
Foley catheter
Viral infection
Bladder instillation
Transurethral catheter

Additional relevant MeSH terms:
Urinary Bladder Diseases
Urologic Diseases
Antiviral Agents
Anti-Infective Agents