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EmphysemaPhase 2DEPTHNCT05382208

Doxycycline for Emphysema in People Living With HIV (The DEPTH Trial)

A Phase 2 study testing Doxycycline in people with Emphysema and HIV, run by Weill Medical College of Cornell University at 20 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The purpose of this study is to determine if doxycycline will reduce progression of emphysema in people living with HIV. The secondary objectives are to examine the effects of doxycycline on change in quantity of emphysema, six minute walk distance, patient reported outcomes, ratio of forced expiratory volume in 1… Read more about this study

Who is it for?
Ages 30 years and older
Conditions the study is for
Emphysema, HIV
What is being tested?
Doxycycline
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
133 participants
Where
20 sitesUnited States
Study dates
22 Aug 2022to Feb 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 30 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female age 30 years and older at screening visit.
  • HIV-1 infection, documented by any licensed rapid HIV test or HIV enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to the enrollment visit, and confirmed by a licensed Western blot or a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by HIV-1 antigen, plasma HIV-1 RNA viral load.
  • Current or former smoker with at least a 3 pack-year history of cigarette smoking at screening visit.
  • Evidence of emphysema on high resolution CT (HRCT) of the chest done at pre-entry visit (Visit 2). Emphysema is defined as either:
  • Mild, moderate, or severe emphysema assessed by central reader(s) at the CT Imaging Core; or
  • Quantification of ≥ 5% of voxels with density < -950 Hounsfield Units (HU) as quantified by the CT Imaging Core.
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  • All participants with emphysema by either or both criteria must have ≤ 35% of voxels with density < -950 HU.
  • Screening and Entry DLCO measurements must be within 15% of each other. The PFT quality at both visits must be acceptable based on ATS Quality Criteria.
  • Screening (Visit 1) Pulmonary Function Test meets ATS quality criteria as determined by a central reviewer at the PFT Reading Core (UCLA)
  • Baseline (Visit 2) Pulmonary Function Test meets ATS quality criteria as determined by the central reviewer at the PFT Reading Core (UCLA), Site Investigator, or DEPTH Trial Leadership.
  • HIV-1 RNA level < 200 copies/ml within 90 days prior to the Entry/Baseline visit by any US laboratory that has a Clinical Laboratory Improvement Amendments (CLIA) certification or its equivalent.
  • CD4 cell count > 100 cells/mm3 within 90 days prior to the Entry/Baseline visit.by any US laboratory that has a CLIA certification or its equivalent.
  • Stable antiretroviral therapy for greater than or equal to 8 weeks prior to the Entry/Baseline visit. Substitutions of one formulation of a drug for another are not considered changes in antiretroviral therapy for the purpose of defining stable therapy..
  • Serum ALT and AST < 3 x upper limit of normal within 60 days prior to the Entry/Baseline visit.
  • Participants on therapy for COPD must be on stable therapy for at least 4 weeks prior to the Entry/Baseline visit.
  • Documentation of serum alpha-1-antitrypsin level above the lower limit of normal from a test done at any time prior to the Entry/Baseline visit.
  • Provision of signed and dated written informed consent.
  • Stated willingness to adhere to all study procedures and anticipated availability for the duration of the study.
  • Life expectancy > 2 years in the opinion of the site investigator.
  • Ability to take oral medication and willingness to adhere to the study drug.
  • For individuals of reproductive potential, negative serum or urine pregnancy test with a sensitivity of less than or equal to 25 mIU/mL at the screening visit. This will be repeated at the Entry/Baseline visit.

Who cannot join

  • Pulmonary infection, acute COPD exacerbation, acute opportunistic infection within 30 days prior to the Screening Visit 1 or Entry/Baseline Visit 2.
  • Any acute or serious illness requiring systemic treatment and/or hospitalization within 30 days prior to the Entry/Baseline visit.
  • Decompensated cirrhosis defined as an acute deterioration in liver function in a patient with cirrhosis and is characterized by jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome or variceal hemorrhage.
  • History of, or planned, wedge resection, lobectomy, pneumonectomy, or lung volume reduction surgery.
  • History of, or planned, endobronchial valve placement for lung volume reduction.
  • Significant parenchymal lung disease other than emphysema or chronic bronchitis (e.g. sarcoidosis, MAI infection, pulmonary fibrosis, lung cancer, bullae/cysts from prior Pneumocystis pneumonia) that would preclude accurate quantification of emphysema.
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  • Previous allergy or intolerance to doxycycline or other drugs in the tetracycline class (e.g. minocycline, tetracycline).
  • Breastfeeding individuals.
  • Receipt of any investigational* drug within 30 days prior to the Entry/Baseline visit. Note: for the purpose of this protocol, investigational drug refers to a drug that is not FDA approved for any indication. COVID vaccines available under emergency use authorization are allowed.
  • Need for concomitant use of barbiturates; carbamazepine; phenytoin
  • Use of systemic retinoids (eg. Isotretinoin [Accutane]) or Vitamin A within 30 days prior to the Entry/Baseline visit. Note: Multivitamin containing Vitamin A use is permitted.
  • Use of any systemic antibiotic (e.g., doxycycline or other tetracycline, azithromycin) within 7 days prior to the Entry/Baseline visit.
  • Any condition including active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
  • History of recurrent C. difficile infection or C. difficile infection within 30 days prior to the Entry/Baseline visit.
  • Inability to stop supplemental oxygen for 15 minutes to perform a DLCO maneuver.
  • Has changes to the chest that preclude adequate HRCT imaging (e.g. Metallic objects in the chest such as shrapnel or pacemaker leads)
  • Current receipt of, or anticipated need to initiate, hemodialysis or peritoneal dialysis.

Trial locations and contacts

20 sites in 1 country.

20 sites in 1 country

United States20 sites
  • Emory University

    Atlanta, Georgia, 30329

  • Johns Hopkins University School of Medicine

    Baltimore, Maryland, 21287

  • University of Alabama at Birmingham

    Birmingham, Alabama, 35233

  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • SUNY Downstate Medical School

    Brooklyn, New York, 11203

  • University of North Carolina

    Chapel Hill, North Carolina, 27514

  • University of Cincinnati College of Medicine

    Cincinnati, Ohio, 45267

  • Case Western University

    Cleveland, Ohio, 44106

  • Ohio State University

    Columbus, Ohio, 43210

  • Duke University School of Medicine

    Durham, North Carolina, 27704

  • University of Texas, McGovern Medical School

    Houston, Texas, 77030

  • University of California Los Angeles

    Los Angeles, California, 90095

  • Miami University

    Miami, Florida, 33136

  • Tulane University

    New Orleans, Louisiana, 70112

  • Weill Cornell Medicine

    New York, New York, 10065

  • Temple University

    Philadelphia, Pennsylvania, 19140

  • University of Pittsburgh

    Pittsburgh, Pennsylvania, 15261

  • University of California San Diego

    San Diego, California, 92103

  • University of Washington

    Seattle, Washington, 98104

  • Washington University School of Medicine

    St Louis, Missouri, 63110

Other trials in United States

About this study

The purpose of this study is to determine if doxycycline will reduce progression of emphysema in people living with HIV.

The secondary objectives are to examine the effects of doxycycline on change in quantity of emphysema, six minute walk distance, patient reported outcomes, ratio of forced expiratory volume in 1 second and forced vital capacity. Secondary objectives will also describe the safety and tolerability of doxycycline and determine if doxycycline is associated with development of antibiotic-resistant bacterial infections.

Read the detailed description

This study is a phase II, multicenter, randomized, double-blinded, placebo-controlled clinical trial in approximately 250 people living with HIV who have emphysema.

Eligible participants will be randomized in a 1:1 fashion to doxycycline or placebo. Participants will receive 100 mg doxycycline orally or matched placebo twice a day for 72 weeks.

Conditions
Emphysema, HIV
Being tested
Doxycycline, Placebo
Medical subject headings
Emphysema

What participants receive

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

  • DoxycyclineDrug

    Doxycycline 100 mg orally twice a day.

  • PlaceboDrug

    Matching placebo orally twice a day.

Study groups in NCT05382208
Study groupRoleWhat they receive
DoxycyclineExperimentalDoxycycline 100mg orally twice a day
Receives: Drug: Doxycycline
PlaceboPlacebo comparatorMatching placebo orally twice a day
Receives: Drug: Placebo

What is being measured

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

  1. Rate of decline (slope) of percent predicted diffusing capacity for carbon monoxide (DLCO) corrected for hemoglobin, carboxyhemoglobin and barometric pressure (indicated as ppDLCOadj) over the 72 week treatment period.

    Measured: 72 weeks

Secondary outcomes (22)
  1. Change from baseline to week 48 in 6 minute walk test distance.

    Measured: 48 weeks

  2. Change from baseline to week 72 in 6 minute walk test distance.

    Measured: 72 weeks

  3. Change from baseline to week 48 in percent predicted diffusing capacity for carbon monoxide (DLCO) corrected for hemoglobin, carboxyhemoglobin and barometric pressure (ppDLCOadj).

    Measured: 48 weeks

  4. Change from baseline to week 72 in percent predicted diffusing capacity for carbon monoxide (DLCO) corrected for hemoglobin, carboxyhemoglobin and barometric pressure (ppDLCOadj).

    Measured: 72 weeks

  5. Change from baseline to week 72 in percentage of voxels < -950 Hounsfield Units (HU)

    Measured: 72 weeks

  6. Change from baseline to week 48 in the COPD Activity Test (CAT) score

    The COPD Assessment Test (CAT): CAT is an 8-item self-administered questionnaire. Scores range from 0 to 40. Higher scores denote a more severe impact of COPD on a patient's life.

    Measured: 48 weeks

  7. Change from baseline to week 72 in the COPD Activity Test (CAT) score

    The COPD Assessment Test (CAT): CAT is an 8-item self-administered questionnaire. Scores range from 0 to 40. Higher scores denote a more severe impact of COPD on a patient's life.

    Measured: 72 weeks

  8. Change from baseline to week 48 in St. George's Respiratory Questionnaire (SGRQ) score

    St. George's Respiratory Questionnaire (SGRQ): SGRQ is a 50-item respiratory disease-specific health-related quality of life (HRQOL) instrument designed to measure impact on overall health, daily life, and perceived well-being in patients with obstructive airways disease. Scores range from 0 to 100, with higher scores indicating more limitations.

    Measured: 48 weeks

  9. Change from baseline to week 72 in St. George's Respiratory Questionnaire (SGRQ) score

    St. George's Respiratory Questionnaire (SGRQ): SGRQ is a 50-item respiratory disease-specific health-related quality of life (HRQOL) instrument designed to measure impact on overall health, daily life, and perceived well-being in patients with obstructive airways disease. Scores range from 0 to 100, with higher scores indicating more limitations.

    Measured: 72 weeks

  10. Change from baseline to week 48 in forced expiratory volume in 1 second (FEV1) (L)

    Measured: 48 weeks

  11. Change from baseline to week 72 in forced expiratory volume in 1 second (FEV1) (L)

    Measured: 72 weeks

  12. Change from baseline to week 48 in the ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC)

    Measured: 48 weeks

  13. Change from baseline to week 72 in the ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC)

    Measured: 72 weeks

  14. The number of adverse events

    The number of adverse events regardless of relatedness to the intervention

    Measured: 72 weeks

  15. The proportion of participants with at least 1 adverse event

    The proportion of participants with at least 1 adverse event regardless of relatedness to the intervention

    Measured: 72 weeks

  16. The number of serious adverse events.

    Serious adverse events (SAEs) will include all treatment-emergent SAEs.

    Measured: 72 weeks

  17. The proportion of participants with at least 1 serious adverse event.

    The proportion of participants with at least 1 Serious adverse event (SAE). SAEs will include all treatment-emergent SAEs.

    Measured: 72 weeks

  18. The proportion of participants with deaths.

    Measured: 72 weeks

  19. The number of participants permanently discontinuing study medication due to adverse events.

    The number of participants permanently discontinuing study medication due to treatment-emergent adverse events.

    Measured: 72 weeks

  20. The proportion of participants permanently discontinuing study medication due to adverse events.

    The proportion of participants permanently discontinuing study medication due to treatment-emergent adverse events.

    Measured: 72 weeks

  21. The number of participants with development of culture proven antibiotic-resistant bacterial infection with reduced susceptibility or resistance to doxycycline (adverse event of special interest).

    Measured: 72 weeks

  22. The proportion of participants with development of culture proven antibiotic-resistant bacterial infection with reduced susceptibility or resistance to doxycycline (adverse event of special interest).

    Measured: 72 weeks

Timeline

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

  1. First posted19 May 2022
  2. Study start22 Aug 2022
  3. Primary completionFeb 2027 (estimated)
  4. Study completionFeb 2027 (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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
133 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05382208
Sponsor's protocol ID
22-02-307/22-04024723
Other IDs
DEPTH-001, UH3HL154944
Acronym
DEPTH
Status last verified
Jan 2026
First submitted
16 May 2022
Last updated
26 Jan 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: The de-identified analytic data will be prepared as SAS transport files or ASCII comma-delimited files with accompanying codebooks that describe the data and data structure. The redaction will employ best practices and will be consistent with NHLBI data sharing policies.

Publications

  • Kaner RJ, O'Beirne SL, Krambrink A, Spino C, Yang HS, Zhu YS, Crystal RG, Glesby MJ. Randomized Double-Blinded Pilot Study of Doxycycline for HIV-Associated COPD and Emphysema. Chronic Obstr Pulm Dis. 2026 Sep 30. doi: 10.15326/jcopdf.2026.0796. Online ahead of print.

    PubMed 42852919

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Doxycycline in people with Emphysema and HIV, run by Weill Medical College of Cornell University at 20 sites 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 21 inclusion and 17 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: under way, not looking for participants, as of the sponsor's last update on 26 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rate of decline (slope) of percent predicted diffusing capacity for carbon monoxide (DLCO) corrected for hemoglobin, carboxyhemoglobin and barometric pressure (indicated as ppDLCOadj) over the 72 week treatment period. (time frame: 72 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05382208, which also lists 1 linked publication.

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 26 Jan 2026.

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