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A Pilot, Randomized Open-Label Study Comparing the Safety, Tolerability and Pharmacokinetics (PK) of Amantadine Hydrochloride and Ribavirin With Oseltamivir Phosphate (TCAD) Administered Orally Versus Neuraminidase Inhibitor Monotherapy (Zanamivir or Oseltamivir) Administered Orally or Via Inhaler to Influenza A Virus Infected Immunocompromised Patients


Phase 1/Phase 2
1 Year
N/A
Not Enrolling
Both
Influenza

Thank you

Trial Information

A Pilot, Randomized Open-Label Study Comparing the Safety, Tolerability and Pharmacokinetics (PK) of Amantadine Hydrochloride and Ribavirin With Oseltamivir Phosphate (TCAD) Administered Orally Versus Neuraminidase Inhibitor Monotherapy (Zanamivir or Oseltamivir) Administered Orally or Via Inhaler to Influenza A Virus Infected Immunocompromised Patients


Inclusion Criteria:



i. Inclusion criteria for randomized arms (both needed):

1. Age ≥7 years, male or female; AND

2. Influenza infection (i.e. upper respiratory tract infection)

ii. Inclusion criteria for open-label arm (at least one criteria required):

1. Young age (1-6 years) with any influenza severity, proven or probable influenza A
(H1N1)(H274Y); OR

2. History of asthma; OR

3. Older age (≥ 7 years), with no asthma; AND

- moderate to severe influenza; AND/OR

- failure in randomized study monotherapy arm iii. Inclusion criteria for all
subjects:

1. Able to provide informed consent, or for whom consent may be provided by guardian 2.
Immunocompromised, as defined by one of the following:

- Recent hematopoietic cell transplantation (HCT) (within 2 years, all conditioning
regimens, allogeneic, autologous, syngeneic; after 2 years patients with chronic
graft-versus-host disease (GVHD) requiring systemic treatment may be included) or
solid organ transplantation

- Patients taking at least 2 immunosuppressants

- Patients undergoing combination chemotherapy within the past 3 month 3. One or more
of the following:

- Presence of fever at time of screening of ≥ 38.0°C (≥ 100.0°F) taken orally.

- presence of at least one constitutional symptom (headache, myalgia, malaise, or
fatigue) of any severity (mild, moderate, or severe),

- presence of at least one respiratory symptoms (e.g. cough, or sore throat) of any
severity (mild, moderate, or severe),

- other flu-like symptoms, where the clinician orders a respiratory virus test
including influenza A or B 4. Positive test for influenza A (if available) 5. Onset
of illness no more than 5 days prior to diagnosis. 6. Females patients of
child-bearing age who are capable of conception (i.e. previously have not undergone
surgical sterilization) must meet the following criteria:

- Have been sexually abstinent or have used contraceptive agents (oral contraceptive or
other hormonal contraceptives including vaginal rings or transdermal patches,
intrauterine device (IUD), or barrier methods including condoms) during the 4 weeks
prior to date of screening (3 months prior to enrollment for oral/hormonal
contraceptives)

- Agree to be sexually abstinent or use contraceptive agents (oral contraceptive or
other hormonal contraceptives including vaginal rings or transdermal patches,
intrauterine device (IUD), or barrier methods including condoms) from the date of
screening through 24 weeks after the last dose of study drug

Exclusion Criteria(all subjects):

1. Nausea that prevents taking oral medications

2. Use of antiviral influenza medication within 10 days(unless switched from randomized
to open-label TCAD). An exception to this exclusion criterion may be made by site
investigators for patients admitted after hours who receive one or two initial doses
of antiviral influenza medication prior to enrollment.

3. Creatinine clearance (estimated by serum creatinine) less than 30 ml/min

4. Current clinical evidence of a recognized or suspected uncontrolled non-influenza
infectious illness with onset prior to screening

5. Known hypersensitivity to amantadine, ribavirin, oseltamivir or zanamivir

6. Women who are pregnant (positive serum or urine pregnancy test), who are attempting
to become pregnant, or who are breast-feeding

7. Psychiatric or cognitive illness, or recreational drug/alcohol use that, in the
opinion of the principal investigator, would affect patient safety and/or compliance

8. Uncontrolled seizure disorder or history of a seizure activity within 12 months prior
to study participation

9. Any significant finding in the patient's medical history or physical exam on Day 1
that, in the opinion of the investigator, would affect patient safety or compliance
with the dosing schedule

10. Documented Influenza B viral co-infection

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Number of Participants With Adverse Events (AEs), Drug Specific AEs or AEs Resulting in Treatment Interruption

Outcome Description:

Abnormal lab data or newly appeared symptoms & signs were considered as AEs. Examined lab data: Blood cell count (WBC, differential count, RBC, Hemoglobin, Hematocrit, MCV, MCHC, platelets), Chemistry (Cl, HCO3, K, Na), Renal function test (BUN, Creatinine, Creatinine clearance), Liver function test (AST, ALT, T.Bil, gamma-glutamyltransferase)

Outcome Time Frame:

30 days after the final dose of study drug

Safety Issue:

Yes

Principal Investigator

Michael Boeckh, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Fred Hutchinson Cancer Research Center

Authority:

United States: Institutional Review Board

Study ID:

2323.00

NCT ID:

NCT00867139

Start Date:

March 2009

Completion Date:

January 2010

Related Keywords:

  • Influenza
  • Influenza
  • Immunocompromised
  • Antiviral
  • Influenza, Human

Name

Location

Fred Hutchinson Cancer Research CenterSeattle, Washington  98109
Seattle Children'SSeattle, Washington  98105