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HIV DementiaPhase 3NCT01599975

A Study Comparing Long-acting Methylphenidate (ConcertaTM) vs. Placebo in the Treatment of Memory Loss Due to HIV

A Phase 3 study testing Long acting methylphenidate in people with HIV Dementia, run by University of California, Los Angeles at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study is being done to see if a drug called long acting methylphenidate (Concerta) is safe and effective as a treatment for problems with mental function in adults infected with HIV. A subset of patients with HIV-associated memory loss have a defect in the speed with which they learn and process information. Read more about this study

Who is it for?
Ages 18 to 64 years
Conditions the study is for
HIV Dementia
What is being tested?
Long acting methylphenidate
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
1 siteUnited States
Study dates
May 2012to Sep 2014
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Men and women 18 years of age or older and less than 65 years of age.
  • Able to read and understand English.
  • HIV infected on stable ART regimen for 5 months or greater, and not likely to change regimen for the duration of the study.
  • Significant dementia but able to give consent (International HIV Dementia Scale score <10).
  • Significant cognitive slowing on screening, defined as 1 SD below normal (t-score >60) on the Conner's CPT-II reaction time test.
  • Beck Depression Inventory score <16.
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  • Documented HIV-1 RNA PCR <50 copies/mL and documented CD4 count >200 within 3 months of entry visit.
  • Baseline CBC and chemistry panel Grade 1 or normal.
  • For females of reproductive potential (women who have not been post-menopausal for at least 24 consecutive months, i.e., who have had menses within 24 months prior to study entry), or women who have not undergone surgical sterilization, specifically hysterectomy or bilateral oophorectomy or tubal ligation) will require a negative serum or urine pregnancy test within 48 hours prior to entry.
  • NOTE: Subject reported history is considered acceptable documentation of hysterectomy, bilateral oophorectomy, tubal ligation, tubal micro-inserts, menopause, and vasectomy/azoospermia.
  • All subjects must agree not to participate in the conception process (e.g., active attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization), and if participating in sexual activity that could lead to pregnancy, the subject/partner must use at least two reliable methods of contraception, (condoms, without a spermicidal agent; a diaphragm or cervical cap without spermicide; an IUD; or hormone-based contraceptive), for 2 weeks before study treatment, while receiving study treatment, and for 6 weeks after receiving study treatment.
  • Ability and willingness of subject to provide informed consent.

Who cannot join

  • Inability to give informed consent. No proxy consent allowed.
  • Uncontrolled hypertension (SBP >140 and DBP >90 at screening and baseline).
  • Untreated hypogonadism, hypothyroidism or hyperthyroidism.
  • Initiation of antidepressants, thyroid medication or anabolic steroids within 6 weeks of screening visit.
  • Pregnancy or breast feeding.
  • Clinically significant EKG abnormalities at screening.
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  • History of coronary artery disease, atherosclerotic disease, left ventricular hypertrophy, cardiomegaly, syncope, congestive heart failure, myocardial infarction, pacemaker, clinically significant arrhythmia, angina, history of treatment for arrhythmia.
  • Brain related opportunistic infections, stroke, intracranial lesions/disease, or meningitis.
  • History of epilepsy.
  • Untreated depression.
  • Uncontrolled diabetes (glucose <70 or >200 at screening).
  • Use of interferon or ribavirin during study and for 1 month prior to screening.
  • History of bipolar disorder, Alzheimer's dementia, ALS, Parkinson's disease or other medical dementias other than HIV-related.
  • History of schizophrenia, mania or other serious mental illness.
  • History of methylphenidate allergy.
  • Other serious concurrent medical illness other than HIV.
  • History of radiation therapy to the brain or brain injury.
  • History of crystal methamphetamine, cocaine, LSD use or other recreational substance use other than marijuana within the 12 months prior to screening and for the duration of the study.
  • Plan to use marijuana or marinol during the entire study duration and one month prior to screening visit.
  • Plan to drink 7 or more alcoholic drinks per week during the 4 weeks prior to screen visit and for the duration of the study.
  • History of alcohol dependence, alcohol abuse, cocaine addiction, crystal methamphetamine addiction or other recreational drug addiction or treatment for addiction or dependence within 5 years of screening visit.
  • If subject is using prescription narcotics, should be on a stable dose for at least 1 month prior to screening and throughout the study.
  • Previous use of Concerta™, Ritalin™, atomexitine or Adderall™ or other psychostimulants (e.g. modafinil, armodafinil) for 3 months prior to screening visit and for duration of the study.
  • History of tic disorders in the past 3 months or any history of Tourette's syndrome.
  • Greater than 10% below ideal body weight (IBW for men = 50 kg + 2.3 kg per inch over 5 feet of height, and IBW for women = 45.5 kg + 2.3 kg per inch over 5 feet of height)
  • Uncontrolled migraine headaches.
  • History of short gut syndrome, Meckel's diverticulum, or cystic fibrosis.
  • Family history of sudden cardiac death in a young relative.
  • History of fainting with exercise.
  • History of attention deficit disorder will be excluded, defined as a score greater than 6 on the Childhood ADHD Symptoms Scale.
  • -

Trial locations and contacts

1 site in 1 country.

Alejandro T. Ponce, M.D. contact

310 557 9916

aponce@mednet.ucla.edu

Ardis A. Moe, M.D. contact

310 557 2273

amoe@mednet.ucla.edu

United States1 site, 1 recruiting
  • UCLA CARE Clinic

    Los Angeles, California, 90035

    Alejandro T. Ponce, M.D., 310-557-9916, aponce@mednet.ucla.edu

    Ardis A. Moe, M.D., 310 557 2273, amoe@mednet.ucla.edu

    Recruiting

Other trials in United States

About this study

Official title: Phase III, Placebo-Controlled, Double-Blind Crossover Study of Slow-Release Methylphenidate (Concerta ™) for Treatment of HIV Associated Neurocognitive Disorder

This study is being done to see if a drug called long acting methylphenidate (Concerta) is safe and effective as a treatment for problems with mental function in adults infected with HIV.

A subset of patients with HIV-associated memory loss have a defect in the speed with which they learn and process information. Methylphenidate drugs, such as Ritalin or Concerta, have been shown on tests to improve the ability to rapidly absorb information; these tests are called "reaction time tests". These drugs are already FDA-approved to treat Attention Deficit Disorders: ADD or ADHD.

At baseline, all subjects get tests of memory and brain function; then they are split into two groups. One group on this study will receive Concerta for 2 weeks, and a second group will receive a placebo x 2 weeks. After that period both groups will receive memory and other tests of brain function, and then the groups will switch. The first group will receive placebo and the second will receive Concerta x 2 weeks, followed by more memory and neurological tests. After that all subjects will have the option to receive Concerta for free for 8 more weeks. At the last visit all subjects get memory and brain tests again.

Read the detailed description

There are 11 study visits in 14 weeks.

In Part I of the study one-half of the subjects will receive ConcertaTM and one-half will receive placebo.

After 2 weeks all subjects will stop their study medication for 2 week (the "washout period"), and then all of the subjects who received placebo will then receive 2 weeks of methylphenidate, and all of the subjects who received long acting methylphenidate will receive placebo for 2 weeks.

The subject will be invited to enter Part II of the study if she/he still qualifies. During this portion of the study, the subject will receive ConcertaTM for 8 weeks. The subject does not have to be on Part II of this study to be on this study.

Screening visit. (4 hours)

There is a screening medical visit. If the subject passes the initial questions for depression and dementia, the subject will undergo the following procedures:

There will be a physical examination including a medical and medication history, which will include telling the study staff about all of the drugs that the subject has taken recently or are currently taking, and measurement of vital signs (blood pressure, temperature, height, weight, pulse,breathing rate).

The subject will have a physical examination including a detailed test of reflexes, muscle strength,gait, balance, and other functions of brain and nerves to see if he/she has any nerve damage and to see how the brain functions. The subject will take a group of tests called neuropsychological tests. The subject will answer questions, do simple tasks with their hands, and see how long it takes her/him to walk a short distance. Some of these questions are to test the subject for depression and memory abilities.

The subject will need to bring in your most recent CD4 cell count (T-cell counts) and HIV viral load on this visit.

If the initial screening questionnaires show that the subject fulfills some of the requirements of the study, the subject will be asked to have about 2 tablespoons of blood drawn from a vein in his/her arm, a urine test for drugs of abuse, and a urine pregnancy test if the subject is female and able to bear children. Some of the blood tests are to measure liver and kidney function and to see if the subject is anemic. The subject will have an EKG (electrocardiogram).

. Entry Visit (Week 0) If the subject qualifies for this study the subject will return to the clinic for an entry visit. The entry visit will occur within 2 weeks of Visit 1. This visit will take about 3-4 hours. At this visit you will undergo the following procedures: The subject will have a short physical examination and be asked questions about your health and the medications she/he is taking. The subject will be asked to complete another set of tests of memory and mental function. If the subject is a woman of child bearing potential he/she will have a pregnancy test at this visit and every 4 weeks thereafter. Once the subject has completes the entry tests, she/he will be assigned by chance (like flipping a coin) to either ConcertaTM, or placebo.

The study treatment groups are:

Group A: ConcertaTM 2 tablets taken with food in the morning OR Group B: Placebo, 2 tablets taken with food in the morning.

The first dose of study medication will be given in the clinic. She/he will be asked to take 1 tablet of study medication in the clinic and be observed for 2 hours afterward to see if you have any immediate side effects. The blood pressure will be checked again. The first dose of study medication is only 1 tablet of the study medication. On the day after this clinic visit she/he will take your second dose of study medication. This will be 2 tablets of study medication. Thereafter the subject will be taking 2 tablets of study medication in the morning. The study medications will be given as a 2-week supply.

Week 1 Visit (1 hour) The subject will be asked brief medical questions and receive a brief physical exam with vital signs and an EKG if indicated. She/he will be asked for a urine sample. She/he will have one short memory test.

Week 2 Visit (3 hours) He/she will be asked to come to clinic before he/she takes the daily dose of study medication. He/she are asked to bring your study medications with them, and to take the study medication in the presence of the study staff, who will note the time. He/she will be asked brief medical questions and receive a brief physical exam and a detailed test of his/her brain and nerve function. He/she will have an EKG and a blood test of about 2 tablespoons to check liver and kidney function, and to check for anemia.

She/he will also be asked questions about emotions, memory function, and ability to do simple tasks. If she is a woman able to become pregnant she will be asked to have a urine pregnancy test. After this visit the subject will stop taking study medications for 2 weeks (2 week washout period).

Week 4 (4 hours) He/she will be asked brief medical questions and receive a brief physical exam, and a detailed test of brain and nerve function. He/she will be asked questions about emotions, memory function, and ability to do simple tasks. He/she will be given a new supply of study medications. The subject will be asked to take 1 tablet of study medication in the clinic and be observed for 2 hours afterward to see if he/she has immediate side effects. Blood pressure will be checked again. On the day after this clinic visit the subject will take 2 tablets of study medication. Thereafter the subject will be taking 2 tablets of study medication in the morning.

Week 5 (1 hour) The subject will be asked brief medical questions and receive a brief physical exam and an EKG if indicated. The subject will be asked for a urine sample. He/she will have one short memory test.

Week 6 (4 hours) The subject will be asked to come to clinic before he/she takes the daily dose of study medication. The subject is asked to bring your study medications with them, and to take the study medication in the presence of the study staff, who will note the time. He/she will be asked brief medical questions and receive a physical exam and a detailed test of brain and nerve function. The subject will be asked questions about emotions, memory function, and ability to do simple tasks. The subject will have a blood test (about 2 tablespoons) to check kidney and liver function, and to check for anemia. The subject will have an EKG. If she is a woman able to become pregnant she will be asked to have a urine pregnancy test.

After the Week 6 visit is completed, and if blood and other tests indicate that the subject is still eligible, the subject will be invited to enter the Part II phase of the study. In the Part II phase,and sign a new consent. In Part II all subjects will receive ConcertaTM for the next 8 weeks. After the new consent is signed, the subject receives a two week supply of Concerta.

Week 8 (1 hour) The subject will be asked brief medical questions and receive a brief physical exam and an EKG if indicated. He/she will be given a 2 week supply of Concerta.

Week 10 (1 hour) The subject will be asked brief medical questions and receive a brief physical exam and an EKG if indicated. If she is female she will be asked to give urine for a pregnancy test .The subject will be given a new 2-week supply of Concerta.

Week 12 (1 hour) The subject will be asked brief medical questions and receive a brief physical exam and an EKG if indicated. He/she will be given a 2 week supply of Concerta.

Week 14 (4 hours) The subject will be asked brief medical questions and receive a physical exam including vital signs and a detailed test of brain and nerve function. He/she will be asked questions about emotions, memory function, and ability to do simple tasks. She/he will again receive memory questionnaires and a quality of life questionnaire. She/he will receive an EKG. If she is a woman able to become pregnant she will be asked to have a urine pregnancy test. After thisvisit the study ends.

Conditions
HIV Dementia
Being tested
Long acting methylphenidate, Matched placebo
Keywords
HAND, HIV Associated Neurocognitive Disorder, Methylphenidate, HIV Dementia
Medical subject headings
AIDS Dementia Complex

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Long acting methylphenidateDrug

    Also called Concerta

    Treatment with long-acting methylphenidate, 36 mg a day as 2 tablets of 18 mg each.

  • Long acting methylphenidateDrug

    18 mg tablets, 2 tablets daily by mouth x 2 weeks, then washout x 2 weeks, then crossover to 2 tablets of matched placebo x 2 weeks.

  • Matched placeboDrug

    Also called Matched placebo as supplied by Johnson and Johnson

    2 tablets of matched placebo daily by mouth

Study groups in NCT01599975
Study groupRoleWhat they receive
Group A: 2 tabs of 18 mg Concerta dailyActive comparator20 subjects to receive active study drug in a blinded fashion x 2 weeks, then washout x 2 weeks, then cross over to receive matched placebo x 2 weeks.
Receives: Drug: Long acting methylphenidate
Group B: Matched placebo, 2 tabs dailyPlacebo comparatorGroup B to receive matched placebo x 2 weeks, then washout x 2 weeks, then cross over to receive active drug in a blinded fashion x 2 weeks.
Receives: Drug: Matched placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in rate of reaction time as measured by neuropsychological testing

    The Conner's CPT-II at screening, and at weeks 1, 5, and 14.

    Measured: 10 weeks of study drug exposure

Secondary outcomes (1)
  1. Number of Subjects with Adverse Events as Measures of Safety and Tolerability of Concerta in HIV infected adults

    The number of subjects who develop adverse events while on study medication vs placebo will be used to measure the safety and tolerability of ConcertaTM at 36 mg a day in this population of adult subjects with HIV over both a two week and eight week treatment period. These measures are EKG changes, electrolyte, creatinine, liver function tests, blood pressure, quality of life and sleep quality scales.

    Measured: 10 weeks of drug exposure

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 May 2012 (estimated)
  2. Study startMay 2012
  3. Primary completionMay 2014 (estimated)
  4. Study completionSep 2014 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01599975
Sponsor's protocol ID
Concerta HIV Study
Status last verified
May 2012
First submitted
7 May 2012
Last updated
16 May 2012
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Long acting methylphenidate in people with HIV Dementia, run by University of California, Los Angeles at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 31 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 16 May 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Alejandro T. Ponce, M.D. (310 557 9916, aponce@mednet.ucla.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in rate of reaction time as measured by neuropsychological testing (time frame: 10 weeks of study drug exposure). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 May 2012.

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