Brief Title
Effects of a Uridine Supplement on HIV Infected Adults With Lipoatrophy
Official Title
A Phase II/III, Randomized, Double-Blind, Placebo-Controlled Trial of Uridine Supplementation in HIV Lipoatrophy
Brief Summary
Lipoatrophy, the loss of body fat from particular areas of the body, is a common side effect of antiretroviral therapy (ART). The purpose of this study was to determine the effectiveness of uridine supplementation in treating HIV infected individuals on stable ART with lipoatrophy.
Detailed Description
Lipoatrophy is a distressing long-term complication of ART and is associated with decreased quality of life, an increased risk of cardiovascular disease, and nonadherence to ART. The cause of lipoatrophy in HIV-infected individuals receiving ART is not completely understood. However, past research suggests that mitochondrial toxicity in subcutaneous adipose tissue caused by thymidine analogue nucleoside analogues may be responsible for the development of lipoatrophy. Uridine is a nucleoside that has been shown to be an effective supplement in treating individuals with mitochondrial toxicity. NucleomaxX is a food supplement that consists of mitocnol, a sugar cane extract that has a high content of nucleosides, including uridine. The purpose of this study was to evaluate the effects of uridine supplementation in the form of NucleomaxX on limb fat in HIV-infected individuals receiving stable ART containing stavudine (d4T) or zidovudine (ZDV). In addition, this study evaluated the safety and tolerability of NucleomaxX. This study lasted for 48 weeks. Participants were randomly assigned to one of two treatment arms, stratified by d4T or ZDV use. Arm A participants received NucleomaxX for uridine, while Arm B participants received a placebo for NucleomaxX. Participants in both arms received their assigned intervention three times per day, every other day, for the duration of the study. There were 8 study visits over the 48-week study duration. Blood collection and a physical exam occurred at all study visits, and participants completed an adherence assessment at most visits. Participants underwent dual energy X-ray absorptiometry scans (DEXA) within 14 days prior to or following the screening visit and at other selected visits. Specific fasting tests for glucose and lipid levels occurred at selected visits. ART was not provided by this study.
Study Phase
Phase 2/Phase 3
Study Type
Interventional
Primary Outcome
Change in Limb Fat (g) From Baseline
Secondary Outcome
Time to Safety Events (Signs/Symptoms or Laboratory Abnormalities)
Condition
HIV Infections
Intervention
NucleomaxX
Study Arms / Comparison Groups
NucleomaxX
Description: Participants received NucleomaxX for 48 weeks
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Drug
Estimated Enrollment
167
Start Date
September 2006
Completion Date
December 2008
Primary Completion Date
December 2008
Eligibility Criteria
Inclusion Criteria: - HIV-1 infected - Stable ART containing zidovudine or stavudine for at least 12 consecutive weeks prior to study entry - Cumulative ART with zidovudine or stavudine for at least 24 weeks prior to study entry - Viral load of 5,000 copies/ml or less within 45 days prior to study entry - Lipoatrophy in at least two of the following areas: face, arms, legs, OR buttocks - Not planning to add to or change current vitamin supplementation - Willing to use acceptable forms of contraception Exclusion Criteria: - Life expectancy of less than 12 months - Currently enrolled in or planning to enroll in an ART interruption study - Plans to change current ART regimen - Liver failure at anytime prior to study entry - Greater than Grade 2 diarrhea or vomiting within 7 days prior to study entry - Current AIDS-defining opportunistic infection or illness. Individuals with cutaneous Kaposi's sarcoma not requiring chemotherapy are not excluded. - Currently receiving insulin or oral hypoglycemic products for diabetes mellitus - Systemic cancer chemotherapy or immunomodulating agents within 30 days prior to study entry - Systemic steroids for a cumulative duration of longer than 4 weeks within the 6 months prior to study entry - Known allergy or sensitivity to study drug or any of its components - Severe lactose intolerance - Current drug or alcohol abuse or dependence - Clinically significant illness requiring systemic treatment or hospitalization - Chronic disability or serious illness that may affect body composition - Received an investigational drug other than NucleomaxX or uridine for lipoatrophy within 30 days prior to study entry - Certain abnormal laboratory values - Pregnancy or breastfeeding
Gender
All
Ages
18 Years - N/A
Accepts Healthy Volunteers
No
Contacts
Grace A. McComsey, MD, ,
Location Countries
Puerto Rico
Location Countries
Puerto Rico
Administrative Informations
NCT ID
NCT00307164
Organization ID
A5229
Secondary IDs
10136
Responsible Party
Sponsor
Study Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Study Sponsor
Grace A. McComsey, MD, Study Chair, Division of Infectious Diseases, Case Western Reserve University
Verification Date
January 2019