Gentian Violet Vs. Nystatin Oral Suspension for Treatment of Oropharyngeal Candidiasis

Last updated: February 12, 2015
Sponsor: AIDS Clinical Trials Group
Overall Status: Completed

Phase

3

Condition

Yeast Infections

Sexually Transmitted Diseases (Stds)

Hiv/aids

Treatment

N/A

Clinical Study ID

NCT01427738
ACTG A5265
1U01AI068636
  • Ages > 18
  • All Genders

Study Summary

The purpose of this study was to see which one of two medicines (topical gentian violet [GV] or nystatin oral suspension) was better than the other in treating Oral Candidiasis (OC). This was measured by whether the study participant still had OC or sores in his/her mouth after 14 days of treatment. Also, safety and tolerability of GV and nystatin in the treatment of OC were assessed.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • HIV-1 infection, documented by any licensed rapid HIV test or HIV enzyme orchemiluminescence immunoassay (E/CIA) test kit at any time prior to study entry andconfirmed by licensed Western blot or a second antibody test by a method other thanthe initial rapid HIV and/or E/CIA, or by HIV-1 antigen, plasma HIV-1 RNA viral load.

  • Pseudomembranous candidiasis documented by a complete oral exam (i.e., white or yellowspots or plaques with an underlying erythematous base, located in any part of the oralcavity) at the screening visit. Participants with documented angular chelitis and/orerythematous candidiasis without pseudomembranous candidiasis were not eligible toenroll in the study.

  • If on an antiretroviral therapy (ART), initiation of regimen at least 12 weeks priorto study entry, and willingness of participant to remain on current ART regimen untilthe study-defined 14-day treatment period was complete. NOTE: Participants who werenot ART-naïve and not on ART were eligible to participate in the study if they did notintend to initiate ART during the study- defined 14-day treatment period.

  • CD4+ cell count obtained within 30 days prior to study entry at a DAIDS-approvedlaboratory.

Exclusion

Exclusion Criteria:

  • Documented or presumptive signs or symptoms of esophageal candidiasis (e.g.,dysphagia) during the screening period unless endoscopic examination of the esophaguswas performed, and fungal esophagitis were excluded.

  • Use of any investigational drug currently or within 30 days prior to study entry.NOTE: For purposes of this study, drugs available under an FDA-authorized expandedaccess program was NOT considered investigational.

  • Concurrent vaginal candidiasis within 21 days prior to study entry.

  • Use of inhaled or systemic corticosteroids within 14 days prior to study entry.

  • Use of any antifungal agents within 30 days prior to study entry.

  • Anticipated need for systemic or oral/topical antifungal agents for other diagnoseswithin the study-defined 14-day treatment period.

  • Intend to initiate ART during the screening period, at study entry, or within thestudy-defined 14-day treatment period.

  • Intend to use any additional oral topical treatments within the study- defined 14-daytreatment period.

  • Known allergy/sensitivity or any hypersensitivity to components of study drugs ortheir formulation.

  • Active drug or alcohol use or dependence that, in the opinion of the siteinvestigator, would interfere with adherence to study requirements.

  • Serious illness, in the opinion of the site investigator, requiring systemictreatment.

  • Hospitalization within 30 days prior to study entry for HIV or HIV-related conditions.

  • Previous or current history of porphyria.

  • Presence of oral warts during the screening period or at the study entry visit beforerandomization.

  • Current wearing of full dentures or a maxillary partial denture at study entry

Study Design

Total Participants: 221
Study Start date:
June 01, 2011
Estimated Completion Date:
January 31, 2014

Study Description

A5265 was a phase III, open-label (both the researchers and participants know which treatment was being administered) clinical trial to compare the safety and efficacy of topical GV to that of oral nystatin suspension. Male and female HIV-1 positive participants ≥ 18 years of age were randomized (as if by the toss of a coin) with equal probability and stratified by CD4+ T-cell counts and the use of antiretroviral therapy at the time of study entry to receive either topical GV solution (5 mL swish and gargle for 1 minute and spit two times daily) or nystatin oral suspension (5 mL swish for 1 minute and swallow four times daily) for 14 days. Therapy was considered as failed if participants have no clinical improvement (assessed by severity of pseudomembranous candidiasis) during either treatment regimen. Evaluation of signs and symptoms of oral candidiasis was done by an evaluator who was blinded to the treatment assignment. A total of 494 participants was expected to enroll in the study but due to early study closure only 221 enrolled; and participants are expected to be on the study for about 13 weeks.

Connect with a study center

  • Gaborone Prevention/Treatment Trials CRS (12701)

    Gaborone,
    Botswana

    Site Not Available

  • Molepolole Prevention/Treatment Trials CRS (12702)

    Molepolole,
    Botswana

    Site Not Available

  • BJ Medical College CRS (31441)

    Pune, Maharashtra 411001
    India

    Site Not Available

  • National AIDS Research Institute Pune CRS (11601)

    Pune, Maharashtra 411026
    India

    Site Not Available

  • AMPATH at Moi Univ. Teaching Hosp. Eldoret CRS (12601)

    Eldoret, 30100
    Kenya

    Site Not Available

  • Walter Reed Project - Kenya Med. Research Institute Kericho CRS (12501)

    Kericho, 20200
    Kenya

    Site Not Available

  • College of Med. JHU CRS (30301)

    Blantyre,
    Malawi

    Site Not Available

  • Durban Adult HIV CRS (11201)

    Durban, 4013 SF
    South Africa

    Site Not Available

  • Joint Clinical Research Centre (JCRC) (12401)

    Kampala,
    Uganda

    Site Not Available

  • UZ-Parirenyatwa CRS (30313)

    Harare,
    Zimbabwe

    Site Not Available

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