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CompletedNCT00000802Updated Nov 4, 2021

A Randomized, Comparative Study of Daily Dapsone and Daily Atovaquone for Prophylaxis Against PCP in HIV-Infected Patients Who Are Intolerant of Trimethoprim and/or Sulfonamides

A Phase 3 interventional study of Atovaquone and Dapsone in Pneumonia, Pneumocystis Carinii and HIV Infections, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 44 sites in 2 countries. Open to participants aged 13 Years and older. Per ClinicalTrials.gov, last updated 2021-11-04.

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
700
Ages
13 Years and older
Sex
All
01

Study summary

To compare the efficacy and safety of dapsone versus atovaquone in preventing or delaying the onset of histologically proven or probable Pneumocystis carinii pneumonia in HIV-infected patients with CD4 counts \<= 200 cells/mm3 or \<= 15 percent of the total lymphocyte count who are intolerant to trimethoprim and/or sulfonamides.

Trimethoprim/sulfamethoxazole (TMP/SMX), which is effective for secondary PCP prophylaxis, is associated with allergic manifestations and side effects that limit its use. Patients who are intolerant of TMP/SMX require an effective alternative. Dapsone and atovaquone have both shown promise as PCP prophylactic agents.

Read the detailed description

Trimethoprim/sulfamethoxazole (TMP/SMX), which is effective for secondary PCP prophylaxis, is associated with allergic manifestations and side effects that limit its use. Patients who are intolerant of TMP/SMX require an effective alternative. Dapsone and atovaquone have both shown promise as PCP prophylactic agents.

Patients are randomized to receive either dapsone or atovaquone daily, with follow-up at the clinic every 4 months.

02

Conditions studied

  • Pneumonia, Pneumocystis Carinii
  • HIV Infections

Keywords

  • Pneumonia, Pneumocystis carinii
  • Dapsone
  • Antifungal Agents
  • Acquired Immunodeficiency Syndrome
  • atovaquone
03

In context

Pneumonia

2,044 studies on the registry are indexed under Pneumonia; 283 are open to participants now.

This study's enrollment of 700 is above the median of 106 across 1,247 interventional studies indexed under Pneumonia.

Browse Pneumonia studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,401 studies on the registry; 179 are open to participants now.

Of its 396 completed or terminated interventional studies of FDA-regulated products, 294 (74%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
13 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Concurrent Medication: Strongly recommended:

  • Pyrimethamine (50 mg) and folinic acid (15 mg) weekly in patients receiving dapsone who have CD4 count \< 100 cells/mm3 and are toxoplasmosis seropositive.

Patients must have:

  • Working diagnosis of HIV infection.
  • CD4 count \<= 200 cells/mm3 or \<= 15 percent of total lymphocyte count at any time in the past OR a history of PCP.
  • History of intolerance of trimethoprim and/or sulfonamides that required permanent discontinuation.

NOTE:

  • Pregnant patients are eligible at the clinician's discretion.

Prior Medication:

Allowed:

  • Prior PCP prophylaxis.

Exclusion criteria

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

  • Active pneumocystosis.

Concurrent Medication:

Excluded:

  • PCP prophylaxis (other than study drug) or any medication with potential anti-PCP activity.

Patients with the following prior conditions are excluded:

  • Known treatment-limiting reaction to dapsone or atovaquone.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Intervention model
Parallel assignment
Enrollment
700 participants

Interventions

  • DrugAtovaquone
  • DrugDapsone
06

Study locations

44 sites
  • Alabama Therapeutics CRS
    Birmingham, Alabama 35294, United States
  • USC CRS
    Los Angeles, California 900331079, United States
  • Stanford CRS
    Palo Alto, California 943055107, United States
  • Ucsd, Avrc Crs
    San Diego, California 921036325, United States
  • Ucsf Aids Crs
    San Francisco, California 941102859, United States
  • Santa Clara Valley Med. Ctr.
    San Jose, California 951282699, United States
  • San Mateo County AIDS Program
    San Mateo, California, United States
  • Harbor-UCLA Med. Ctr. CRS
    Torrance, California 90502, United States
  • University of Colorado Hospital CRS
    Aurora, Colorado 80262, United States
  • Howard University Hosp., Div. of Infectious Diseases, ACTU
    Washington, District of Columbia 20059, United States
  • Univ. of Miami AIDS CRS
    Miami, Florida 331361013, United States
  • Emory Univ. Hemophilia Program Office
    Atlanta, Georgia 303652225, United States
  • Queens Med. Ctr.
    Honolulu, Hawaii 96816, United States
  • Univ. of Hawaii at Manoa, Leahi Hosp.
    Honolulu, Hawaii 96816, United States
  • Northwestern University CRS
    Chicago, Illinois 60611, United States
  • Cook County Hosp. CORE Ctr.
    Chicago, Illinois 60612, United States
  • Rush Univ. Med. Ctr. ACTG CRS
    Chicago, Illinois 60612, United States
  • Weiss Memorial Hosp.
    Chicago, Illinois 60640, United States
  • Indiana Univ. School of Medicine, Infectious Disease Research Clinic
    Indianapolis, Indiana 462025250, United States
  • Univ. of Iowa Healthcare, Div. of Infectious Diseases
    Iowa City, Iowa 52242, United States
  • Johns Hopkins Adult AIDS CRS
    Baltimore, Maryland 21287, United States
  • Bmc Actg Crs
    Boston, Massachusetts 02118, United States
  • Beth Israel Deaconess - East Campus A0102 CRS
    Boston, Massachusetts 02215, United States
  • Massachusetts General Hospital ACTG CRS
    Boston, Massachusetts, United States
  • Hennepin County Med. Ctr., Div. of Infectious Diseases
    Minneapolis, Minnesota 55415, United States
  • University of Minnesota, ACTU
    Minneapolis, Minnesota 55455, United States
  • St. Louis ConnectCare, Infectious Diseases Clinic
    Saint Louis, Missouri, United States
  • Washington U CRS
    Saint Louis, Missouri, United States
  • Univ. of Nebraska Med. Ctr., Durham Outpatient Ctr.
    Omaha, Nebraska, United States
  • SUNY - Buffalo, Erie County Medical Ctr.
    Buffalo, New York 13210, United States
  • Beth Israel Med. Ctr. (Mt. Sinai)
    New York, New York, United States
  • NY Univ. HIV/AIDS CRS
    New York, New York, United States
  • Univ. of Rochester ACTG CRS
    Rochester, New York 14642, United States
  • Unc Aids Crs
    Chapel Hill, North Carolina, United States
  • Carolinas HealthCare System, Carolinas Med. Ctr.
    Charlotte, North Carolina 28203, United States
  • Regional Center for Infectious Disease, Wendover Medical Center CRS
    Greensboro, North Carolina 27401, United States
  • Wake County Health and Human Services CRS
    Raleigh, North Carolina 27610, United States
  • Univ. of Cincinnati CRS
    Cincinnati, Ohio, United States
  • Case CRS
    Cleveland, Ohio 44106, United States
  • MetroHealth CRS
    Cleveland, Ohio, United States
  • The Ohio State Univ. AIDS CRS
    Columbus, Ohio 432101228, United States
  • Hosp. of the Univ. of Pennsylvania CRS
    Philadelphia, Pennsylvania 19104, United States
  • University of Washington AIDS CRS
    Seattle, Washington 981224304, United States
  • Mbeya Med. Research Program, Mbeya Referral Hosp. CRS
    Mbeya, Tanzania
07

References and documents

Publications

  • El-Sadr WM, Murphy RL, Yurik TM, Luskin-Hawk R, Cheung TW, Balfour HH Jr, Eng R, Hooton TM, Kerkering TM, Schutz M, van der Horst C, Hafner R. Atovaquone compared with dapsone for the prevention of Pneumocystis carinii pneumonia in patients with HIV infection who cannot tolerate trimethoprim, sulfonamides, or both. Community Program for Clinical Research on AIDS and the AIDS Clinical Trials Group. N Engl J Med. 1998 Dec 24;339(26):1889-95. doi: 10.1056/NEJM199812243392604. PubMed 9862944 ↗
  • Caldwell P, Murphy R, Chan C, Yurik T, Scott J, el-Sadr W. Atovaquone suspension (ATQ) for prophylaxis of Pneumocystis carinii pneumonia (PCP): effects of baseline prophylaxis on safety and efficacy. Int Conf AIDS. 1998;12:297 (abstract no 22178)
  • Murphy R, El-Sadr W, Cheung T, Luskin-Hawk R, Yurik T, Neaton J, Hafner R. Impact of protease inhibitor containing regimens on the risk of developing opportunistic infections and mortality in the CPCRA 034/ACTG 277 study. Conf Retroviruses Opportunistic Infect. 1998 Feb 1-5;5th:113 (abstract no 181)
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 4, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00000802
Lead sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
First posted
Aug 31, 2001
Completion
Jul 1997
Last update
Nov 4, 2021

Study contacts

El-Sadr W
study chair
Luskin-Hawk R
study chair
Murphy R
study chair
View the source record on ClinicalTrials.gov ↗

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