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M94A2853.TXT
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1994-10-25
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Document 2853
DOCN M94A2853
TI Safety and efficacy of ZDV addition to 3TC monotherapy.
DT 9412
AU van Leeuwen R; Boucher C; Reiss P; Schuurman R; Nijhuis M; Danner S;
National AIDS Therapy Evaluation Centre, University of Amsterdam,; The
Netherlands.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):21 (abstract no. 057B). Unique
Identifier : AIDSLINE ICA10/94369722
AB OBJECTIVE: Lamivudine (3TC, (-) enantiomer of 2'-3'-thiacytidine) and
zidovudine (zdv) exhibit in vitro synergistic antiviral activity.
Moreover, an RT mutation encoding for 3TC resistance (Met184-->Val),
results in suppression of resistance against zdv in vitro. In a phase
I/II study to the effects of monotherapy with 3TC in CDC stage II/III or
IV-C2 patients the Val184 mutation was detected after 1-12 weeks of
therapy. In this study transient increases in CD4 counts and sustained
reductions in p24 antigen have been observed. We report on the effects
of zdv addition to 2 different dosages of 3TC. METHODS: Thirty patients
were part of this multi-centre, open-label, non-randomised study with 2
dosages of 3TC: 100mg bid (arm A, 16 pts) and 300mg bid (arm B, 14 pts).
Zdv 200mg tid was added after > or = 24 weeks (in a majority > or = 52
weeks) 3TC monotherapy, or in case of clinical and/or immunological
deterioration. Baseline values were defined as the mean of 2 pre-entry
values (week -4 & 0). This is an interim analysis of the first 36 weeks.
RESULTS: The median baseline CD4 count was 113 (5-95 percentile: 10-315)
cells/mm3; median CD4 percent 11 (1-27)%. 11 pts were p24 antigen
positive; 6 patients had AIDS at the start of the study. The baseline
characteristics of arm A and B were not statistically different. The
most frequently reported (mild) adverse experiences: fatigue (29 pts),
indigestion (25), headache (18), diarrhoea (16), myalgia/arthralgia
(11), abdominal pain (10), night sweats (10), itching (10),
sleeplessness (9), fever (8), anaemia (8), and neutropenia (8). No
differences were detected in the number of adverse events and dose
adjustments between arm A and B. Median % change from baseline levels
for absolute CD4 cell counts and p24 antigen levels are depicted in the
Figure. Analysis of these and other surrogate markers did not reveal
important differences between arm A and B. CONCLUSION: No unexpected
adverse experiences were reported. CD4+ cell counts increased, and
remained above baseline values at 7/8 timepoints in the study, p24
antigen levels were > or = 65% below baseline throughout the study. No
apparent differences were detected in tolerance or efficacy of 200 or
600 mg 3TC. Extended follow-up, as well as data on plasma HIV-1 RNA load
and resistance will be presented. TABULAR DATA, SEE ABSTRACT VOLUME.
DE Acquired Immunodeficiency Syndrome/*DRUG THERAPY Antiviral
Agents/*ADMINISTRATION & DOSAGE Drug Therapy, Combination Human HIV
Core Protein p24/ISOLATION & PURIF Leukocyte Count T4 Lymphocytes
Zalcitabine/*ANALOGS & DERIVATIVES/ADMINISTRATION & DOSAGE/ ADVERSE
EFFECTS Zidovudine/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS CLINICAL
TRIAL CLINICAL TRIAL, PHASE I CLINICAL TRIAL, PHASE II MEETING
ABSTRACT MULTICENTER STUDY
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).