A Phase II, Randomized, Open-Label Trial of a Six-Month Regimen of High-Dose Rifampicin, High-Dose Isoniazid, Linezolid, and Pyrazinamide Versus a Standard Nine-Month Regimen for the Treatment of Adults and Adolescents With Tuberculous Meningitis: Improved Management With Antimicrobial AGents Isoniazid rifampiciN LinEzolid for TBM (IMAGINE-TBM)

Status: Recruiting
Location: See all (18) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

The purpose of this study is to compare a 6-month regimen of high-dose rifampicin (RIF), high-dose isoniazid (INH), linezolid (LZD), and pyrazinamide (PZA) versus the World Health Organization (WHO) standard of care (SOC) treatment for tuberculosis meningitis (TBM).

Eligibility
Participation Requirements
Sex: All
Minimum Age: 15
Healthy Volunteers: f
View:

• Definite, probable, or possible TBM diagnosis wherein the participant is being committed to a full course of SOC anti-TB treatment for TBM in the setting of routine care. CSF, imaging, laboratory, and other results used to determine definite, probable, or possible TBM can be from testing performed as part of routine care, as long as obtained within 21 days prior to study entry

• Absence of HIV-1 infection, as documented by any licensed rapid HIV test or HIV-1 enzyme or chemiluminescence immunoassay (E/CIA) test kit, within 30 days prior to study entry, OR

• HIV-1 infection, documented by any licensed rapid HIV test or HIV-1 E/CIA test kit at any time prior to entry 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 or plasma HIV-1 RNA viral load. Two or more HIV-1 RNA viral loads of \>1,000 copies/mL are also acceptable as documentation of HIV-1 infection, or documentation of HIV diagnosis in the medical record by a healthcare provider

• Documentation within 3 days prior to study entry of stage of disease using BMRC TBM grade.

• The following laboratory values obtained within 3 days prior to study entry:

‣ Serum creatinine ≤1.8 times upper limit of normal (ULN)

⁃ Hemoglobin ≥8.0 g/dL for men, ≥7.5 g/dL for women

⁃ Absolute neutrophil count ≥600/mm3

⁃ Platelet count ≥60,000/mm3

⁃ Alanine aminotransferase (ALT) ≤3 x ULN

⁃ Total bilirubin ≤2 x ULN

• For participants of reproductive potential who have not been post-menopausal for at least 24 consecutive months (i.e., no menses within the preceding 24 months), or participants who have not undergone surgical sterilization, hysterectomy, bilateral salpingectomy, bilateral oophorectomy, or tubal ligation, documentation of a serum or urine pregnancy test result (positive or negative; see protocol for test sensitivity requirement) within 21 days prior to study entry

• Participants with documentation of a positive pregnancy test will be consented using the consent form for pregnant participants.

∙ Participants of reproductive potential with documentation of a negative pregnancy test must agree to use at least one acceptable form of contraception, or abstain from sexual activity that could lead to pregnancy while receiving study treatment and for 30 days after stopping study treatment.

∙ Participants who are not of reproductive potential or whose partner(s) has documented azoospermia are not required to use contraception. Any statement of self-reported sterility or that of the partner's must be entered in the source documents

• Ability and willingness of participant or parent or legally authorized representative (for adolescents or participants unable to provide consent) to provide informed consent/assent

• Ability to comply with the protocol requirements in the opinion of the site investigator

Locations
Other Locations
Brazil
Hospital Nossa Senhora da Conceicao CRS (Site ID: 12201)
RECRUITING
Porto Alegre
Instituto de Pesquisa Clinica Evandro Chagas (IPEC) CRS (Site ID: 12101)
RECRUITING
Rio De Janeiro
India
Byramjee Jeejeebhoy Government Medical College (BJMC) CRS (Site ID: 31441)
RECRUITING
Pune
Kenya
Moi University Clinical Research Center (MUCRC) CRS (Site ID: 12601)
RECRUITING
Eldoret
Kenya Medical Research Institute/Walter Reed Project Clinical Research Center (KEMRI/WRP) CRS (Site ID: 12501)
RECRUITING
Kericho
Malawi
Malawi CRS (Site ID: 12001)
RECRUITING
Lilongwe
Mexico
Nutrición-Mexico CRS (Site ID: 32078)
NOT_YET_RECRUITING
Mexico City
Peru
Barranco CRS (Site ID:11301)
NOT_YET_RECRUITING
Lima
Socios en Salud Sucursal Peru CRS (Site ID: 31985)
NOT_YET_RECRUITING
Lima
Philippines
TB HIV Innovations and Clinical Research Foundation Corp (Site ID: 31981)
NOT_YET_RECRUITING
Cavite
South Africa
Durban International CRS (Site ID:11201)
NOT_YET_RECRUITING
Durban
University of the Witwatersrand Helen Joseph (WITS HJH) CRS (Site ID: 11101)
NOT_YET_RECRUITING
Johannesburg
Thailand
Siriraj Hospital, Mahidol University NICHD CRS (Site ID: 5115)
NOT_YET_RECRUITING
Bangkok
Thai Red Cross AIDS Research Centre (TRC-ARC) CRS (Site ID: 31802)
NOT_YET_RECRUITING
Bangkok
Chiangrai Prachanukroh Hospital NICHD CRS (Site ID: 5116)
RECRUITING
Chiang Mai
United Republic of Tanzania
Kilimanjaro Christian Medical Centre (KCMC) (Site ID: 5118)
NOT_YET_RECRUITING
Moshi
Viet Nam
National Lung Hospital CRS (Site ID: 32483)
RECRUITING
Vĩnh Phúc
Zimbabwe
Milton Park CRS (Site ID: 30313)
RECRUITING
Harare
Contact Information
Primary
ACTG Clinicaltrials.gov Coordinator
ACTGCT.gov@fstrf.org
(301) 628-3348
Time Frame
Start Date: 2023-12-07
Estimated Completion Date: 2029-09-15
Participants
Target number of participants: 330
Treatments
Experimental: Arm A
RIF 35 mg/kg + INH 15 mg/kg + LZD 1200 mg + PZA 25 mg/kg for 2 weeks, followed by RIF 35 mg/kg + INH 10 mg/kg + LZD 1200 mg + PZA 25 mg/kg for 6 weeks, and then RIF 35 mg/kg and INH 10 mg/kg for 16 weeks, for a total of 24 weeks of study treatment.
Active_comparator: Arm B
WHO SOC: RIF 10 mg/kg + INH 5 mg/kg + ethambutol (EMB) 20 mg/kg + PZA 25 mg/kg for 8 weeks, followed by RIF 10 mg/kg and INH 5 mg/kg for 28 weeks, for a total of 36 weeks of study treatment. Up to 15 mg/kg or a maximum of 900 mg daily of oral RIF will be permitted in this arm at clinician's discretion.
Sponsors
Leads: National Institute of Allergy and Infectious Diseases (NIAID)

This content was sourced from clinicaltrials.gov