3rd Conf Retro and Opportun Infect. 1996 Jan 28-Feb 1;:161. Unique
Despite widespread use of combination nucleoside therapy in patients
with AIDS (1993 CDC definition), a clinical benefit has yet to be
demonstrated in terms of delaying opportunistic diseases or death. CPCRA
007 was designed to compare the efficacy of ZDV alone, ZDV given with
ddI, and ZDV given with ddC in delaying disease progression or death in
patients with AIDS. 1113 patients (254 antiretroviral naive, 859
antiretroviral experienced) were randomized openly to ZDV (600mg/d) and
ddI or ZDV and ddC and then randomized in a double blind fashion, in a
2:1 ratio, either to active ddI (400 mg/d) or its placebo or to active
ddC (2.25 mg/d) or its placebo. Baseline characteristics were well
balanced among treatment arms and overall the participants were: 92%
male, 33% African American, 10% Hispanic, 68% homosexual, and 23%
intravenous drug users. The mean CD4+ count was 119 cells/mm3 and the
median prior ZDV use was 6 months. Prior AIDS defining opportunistic
infections and prior Pneumocystis carinii pneumonia (PCP) were present
on enrollment in 32% and 23% of patients respectively. PCP prophylaxis
was required for all participants and did not differ significantly in
terms of the agent selected. All patients were followed for at least 17
months and the median followup was 35 months. 4% of enrollees were lost
to followup. The mean time on blinded study drugs were 13, 14 and 14 in
the ZDV + ddI, ZDV + ddC, and ZDV only groups, respectively. The study
closed to followup on November 30, 1995 and is currently under analysis.
Difference in treatment arms have been analyzed and detailed results
will be reported. The study has important implications for patient
management.
Acquired Immunodeficiency Syndrome/COMPLICATIONS/*DRUG THERAPY/
PHYSIOPATHOLOGY Antiviral Agents/*THERAPEUTIC USE CD4 Lymphocyte Count
Comparative Study Didanosine/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE
Drug Therapy, Combination Female Human Male Pneumonia, Pneumocystis
carinii/PREVENTION & CONTROL Zalcitabine/ADMINISTRATION &
DOSAGE/*THERAPEUTIC USE Zidovudine/ADMINISTRATION & DOSAGE/*THERAPEUTIC
USE ABSTRACT