Marise S. Gottlieb, MD; Robert A. Zackin, ScB; Milan Fiala, MD; David H. Henry, MD; Adrien J. Marcel, MD; Kenneth L. Combs, MD; Jeffrey Vieira, MD; Howard A. Liebman, MD; Lawrence A. Cone, MD; Kathryn S. Hillman, BA; A. Arthur Gottlieb, MD
Gottlieb MS, Zackin RA, Fiala M, Henry DH, Marcel AJ, Combs KL, et al. Response to Treatment with the Leukocyte-derived Immunomodulator IMREG-1 in Immunocompromised Patients with AIDS-related Complex: A Multicenter, Double-Blind, Placebo-Controlled Trial. Ann Intern Med. 1991;115:84-91. doi: 10.7326/0003-4819-115-2-84
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Published: Ann Intern Med. 1991;115(2):84-91.
▪ Objective: To determine if a 6-month course of therapy with IMREG-1, a leukocyte-derived immunomodulator, slows disease progression in patients with AIDS-related complex.
▪ Design: Randomized, double-blind trial.
▪ Setting: Five academic- and three community-based clinics.
▪ Patients: Immunocompromised patients (143) with HIV.
▪ Interventions: IMREG-1 or placebo every 2 weeks (13 doses).
▪ Main Results: Twelve of forty-eight patients on placebo and 5 of 95 patients on IMREG-1 experienced adverse events (AIDS-defining opportunistic infection or neoplasm, wasting syndrome, HIV-associated encephalopathy, or peripheral sensory neuropathy). Based on an intention-to-treat analysis, Kaplan-Meier event probabilities were 26% for the placebo group and 6% for the IMREG-1 group (P < 0.001); based on the Cox proportional hazards model, the relative risk for patients on placebo compared with patients on IMREG-1 was 5.1 (95% Cl, 1.8 to 14.8). The frequency of symptoms significantly increased from baseline in patients receiving placebo. The mean decrease in CD4+ cells from baseline was 80 X 106 cells/L in the placebo group and 29 X 106 cells/L in patients on IMREG-1, with 20% (8) and 38% (32) of patients, respectively, showing a trend toward an increase (P = 0.04). In patients receiving IMREG-1, the size and rate of delayed hypersensitivity responses were larger than in the placebo group.
▪ Conclusions: Patients with AIDS-related complex experienced fewer adverse events and constitutional symptoms after IMREG-1 treatment. The slower loss of CD4+ cells and increased size and rate of delayed hypersensitivity responses most likely reflect the effect of IMREG-1 on the immune system. No toxicity related to IMREG-1 administration was observed.
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HIV, Infectious Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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