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1994-10-25
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Document 2852
DOCN M94A2852
TI Zidovudine & alpha-interferon vs zidovudine alone in HIV infected
persons with CD4+ cell counts of 150-500/mm3--results of the 'ZIDON'
trial.
DT 9412
AU Fernandez-Cruz E; Lang JM; Frissen PH; Chateauvert M; Furner V; Boucher
CA; Dowd P; Stevens J
SO Int Conf AIDS. 1994 Aug 7-12;10(1):21 (abstract no. 059B). Unique
Identifier : AIDSLINE ICA10/94369723
AB OBJECTIVE: To evaluate the efficacy and safety of zidovudine (ZDV) and
lymphoblastoid interferon-alpha (IFN-alpha) combination therapy compared
with ZDV monotherapy in HIV infected subjects with CD4+ T cell counts
between 150 and 500/mm3. METHODS: Patients who had never received ZDV or
IFN-alpha were randomised to ZDV 250 mg twice daily with or without 3MU
IFN-alpha 3 times a week subcutaneously. Subjects were stratified by the
Centers for Disease Control (CDC) 1986 HIV disease classification system
(Group II/III or IV) and were monitored monthly for clinical and safety
parameters, 12 weekly for CD4+ cell counts and serum p24 antigenaemia
and at week 48 for mutations at codon 215 on the reverse transcriptase
gene. The study was designed as a fixed sample size study but was
amended to a sequential design to allow interim analyses after every 20
end-points. End-points were: progression from CDC group II/III to IV,
from group IV non-AIDS to AIDS, or from AIDS to a second AIDS defining
condition. Two CD4+ cell counts of < 50/mm3 or death from an HIV
associated condition were also considered as end-points irrespective of
CDC group on entry. RESULTS: A total of 402 patients were recruited (209
ZDV+IFN-alpha; 193 ZDV) with a median follow-up of 47 weeks. After the
first 20 end-points (ZDV+IFN-alpha 11; ZDV 9), inspection of the data
revealed that the difference between the two groups on the rate of
progression was unlikely to ever be greater than or equal to the 50%
reduction in end-points the study was powered to detect. No major
differences between the treatment groups were seen for CD4+ cell counts
or percentages, p24 antigenaemia or the frequency of 215 mutations. More
adverse experiences, both haematological and subjective, were seen in
the ZDV+IFN-alpha combination therapy group. DISCUSSION AND CONCLUSIONS:
IFN-alpha when combined with ZDV at the dose regimen studied does not
appear to confer any clinically worthwhile benefit compared with ZDV
monotherapy.
DE Combined Modality Therapy Comparative Study Human HIV/GENETICS HIV
Core Protein p24/ISOLATION & PURIF HIV Infections/*DRUG
THERAPY/*THERAPY Interferon-alpha/*ADMINISTRATION & DOSAGE Leukocyte
Count Reverse Transcriptase/GENETICS T4 Lymphocytes
Zidovudine/*ADMINISTRATION & DOSAGE CLINICAL TRIAL MEETING ABSTRACT
RANDOMIZED CONTROLLED TRIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).