Terminé

A Phase I Study of the Safety and Pharmacokinetics of Recombinant CD4 Immunoglobulin G (rCD4-IgG) in HIV-1 Seropositive Women During the Last Trimester of Pregnancy and Their Newborns

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Ce qui est testé

CD4-IgG

Médicament
Qui peut participer

HIV Infections

+ Pregnancy
Jusqu'à 60 ans
Comment se déroule l'étude

Étude de prévention

Phase 1
Interventionnel

Résumé

Sponsor principalNational Institute of Allergy and Infectious Diseases (NIAID)
Dernière mise à jour : 24 juin 2005
Issu d'une base de données validée par les autorités. Revendiquer cette étude

Part 1: To determine both the safety, tolerance, and pharmacokinetic profile (blood levels) of recombinant CD4 immunoglobulin G (rCD4-IgG) by intravenous bolus administration (given through the vein) in women with HIV infection who are in their third trimester (last three months of pregnancy). To determine the safety of maternal/fetal transfer of rCD4-IgG in infants born to mothers entered into the study. To obtain a preliminary indication of the antiviral and immunologic effects of rCD4-IgG in HIV seropositive pregnant women and their newborns. AMENDED: Part 2: To determine the safety profile of rCD4-IgG in HIV-1-infected women at the onset of labor and in their newborns. To determine the extent of placental transfer of rCD4-IgG when administered to the mother at onset of labor. To determine the pharmacokinetics of rCD4-IgG in newborns. To obtain preliminary evidence of the ability of rCD4-IgG to prevent intrapartum transmission of HIV-1 from mother to fetus. An agent that can prevent HIV infection is desirable for those at risk of infection as well as in the pregnant female and newborn populations. Such an agent may help prevent the progression of the disease in infants and children in early stages of infections. In theory, rCD4-IgG has antiviral effects. An agent that can prevent HIV infection is desirable for those at risk of infection as well as in the pregnant female and newborn populations. Such an agent may help prevent the progression of the disease in infants and children in early stages of infections. In theory, rCD4-IgG has antiviral effects. Part 1: Per the original protocol, a total of six pregnant women were enrolled in Groups A and B. Patients in Group A received rCD4-IgG at the onset of labor, and those in Group B received rCD4-IgG twice per week, beginning 1 week before the expected date of delivery. Newborns were not treated in Part 1 of the study. AMENDED: In Part 2 of the study, a total of nine pregnant women are enrolled in Groups C, D, and E and receive a higher dose of rCD4-IgG at the onset of labor. If the mother has not delivered 18 hours after rCD4-IgG injection, a second injection at the same dose is administered; daily injections are given thereafter until delivery. The newborns receive 1 of 3 doses of rCD4-IgG daily for the first 5 days of life. Infants are enrolled sequentially to each dose level.

Titre officielA Phase I Study of the Safety and Pharmacokinetics of Recombinant CD4 Immunoglobulin G (rCD4-IgG) in HIV-1 Seropositive Women During the Last Trimester of Pregnancy and Their Newborns 
Sponsor principalNational Institute of Allergy and Infectious Diseases (NIAID)
Dernière mise à jour : 24 juin 2005
Issu d'une base de données validée par les autorités. Revendiquer cette étude

Protocole

Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.
Détails du design
30 participants à inclureNombre total de participants que l'essai clinique vise à recruter.
Prévention
Cette étude cherche à prévenir l'apparition d'une maladie ou d'un trouble chez des personnes qui ne l'ont pas encore développé. Elles concernent souvent des personnes à risque et testent des vaccins, des changements de mode de vie ou des traitements préventifs.

Comment la nature du traitement est tenue confidentielle
Dans une étude en ouvert, tous les participants ainsi que les chercheurs savent quel traitement est administré. Ce type de protocole est utilisé lorsqu'il n'est pas nécessaire ou pas possible de masquer les traitements.

Autres méthodes de masquage
Simple aveugle
: les participants ignorent le traitement reçu, mais les chercheurs le connaissent.

Double aveugle
: ni les participants ni les chercheurs ne savent quel traitement est administré.

Triple aveugle
: Les participants, les chercheurs et les personnes qui analysent les résultats ne savent pas quel traitement est administré.

Quadruple aveugle
: Les participants, les chercheurs, les personnes qui analysent les résultats et les professionnels de santé en charge du suivi ne savent pas non plus quel traitement est administré.

Éligibilité

Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.
Conditions
Critères
Tout sexeLe sexe biologique des participants éligibles à s'inscrire.
Jusqu'à 60 ansTranche d'âge des participants éligibles à participer.
Volontaires sains non autorisésIndique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.
Conditions
Pathologie
HIV Infections
Pregnancy
Critères

Inclusion Criteria Concurrent Medication: Allowed: * Iron, multivitamins, short courses of treatment for correctable medical problems (e.g., urinary tract infection), oral trimethoprim/sulfamethoxazole (TMP/SMX) or aerosolized pentamidine for prophylaxis of Pneumocystis carinii pneumonia (PCP), prophylactic antifungal therapy, or isoniazid (INH) therapy. * Acetaminophen. * Other supportive therapy (blood and blood products, vaginal creams, antiemetics, antidiarrheals, cough medicines). * Specific agents used during delivery, such as oxytocic agents or anesthetics. Participation in this protocol will not prevent a newborn from receiving any medication. Concurrent Treatment: Allowed: * Blood and blood product transfusions. * Gamma globulin as prophylaxis against infection with varicella virus and hepatitis virus, or RhoGAM in case of maternal-fetal incompatibility. Risk Behavior: Allowed: * Illicit drug use. Patients must be: * In their third trimester of pregnancy, or join the study with their newborn children. * Willing and able to sign informed consent. * Available for follow-up for at least 3 months. * The child should be available for follow-up for at least 1 year after delivery, and preferably longer. Exclusion Criteria Co-existing Condition: Patients with the following conditions or symptoms are excluded: * Medical complications including, but not limited to, insulin dependent diabetes mellitus (IDDM), hypertensive disorders such as severe pre-eclampsia, eclampsia, chronic hypertension, cardiovascular disease including rheumatic or congenital heart disease, collagen vascular disease, endocarditis, and renal disease. * Hematological conditions including, but not limited to, hemoglobinopathies, coagulopathy, idiopathic thrombocytopenic purpura (ITP), and maternal-fetal blood incompatibilities with isoimmunization (e.g., Rh-negative mother with a positive indirect Coomb's test at any time during this pregnancy). * Neurological disease(s) including seizure disorders. * Bronchopulmonary diseases, such as severe asthma. * Evidence of fetal intolerance of the intrauterine environment. Concurrent Medication: Excluded: * Antiretroviral agents: * Suramin, ribavirin, HPA23, phosphonoformate, ansamycin, zidovudine (AZT), didanosine (ddI), or dideoxycytidine (ddC). * Other antiviral drugs, including acyclovir or ganciclovir. * Immunomodulating agents: * Interleukin 2, interferons, thymic hormones, or other agents. * Cytolytic chemotherapeutic agents. * Corticosteroids. * Immunoglobulin preparations. Concurrent Treatment: Excluded: * Radiation therapy. * Regular administration of gamma globulin. Patients with the following are excluded: * Serious medical or surgical complication of the pregnancy and/or delivery that required treatment during delivery or that might compromise the health of the mother or fetus. Any HIV-related complications requiring antiretroviral therapy during the pregnancy, including encephalopathy and opportunistic infections. * Systemic infection requiring IV therapy in the month prior to enrollment in this study (IV treatment for pyelonephritis is permitted). Prior Medication: Excluded: * Recombinant CD4 immunoglobulin G (rCD4-IgG). Excluded within 4 weeks of study entry: * Antiretroviral agents: * Suramin, ribavirin, HPA23, phosphonoformate, ansamycin, zidovudine (AZT), didanosine (ddI), or dideoxycytidine (ddC). * Other antiviral drugs, including acyclovir or ganciclovir. * Immunomodulating agents: * Interleukin 2, interferons, thymic hormones, or other agents. * Cytolytic chemotherapeutic agents. * Corticosteroids. * Immunoglobulin preparations. Prior Treatment: Excluded within 4 weeks of study entry: * Radiation therapy. History of poor medical compliance (at the discretion of the investigator). Current illicit drug use.



Centres d'étude

Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.
Cette étude comporte 2 sites
Suspendu
SUNY - BrooklynBrooklyn, United StatesVoir le site
Suspendu
Texas Children's Hosp / Baylor UnivHouston, United States

Terminé2 Centres d'Étude