A Phase 2 Randomized, Adaptive, Dose-Ranging, Open-Label Trial of Novel Regimens for the Treatment of Pulmonary Tuberculosis

Status: Recruiting
Location: See all (26) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

A5409/RAD-TB is an adaptive Phase 2 randomized, controlled, open-label, dose-ranging, platform protocol to evaluate the safety and efficacy of multidrug regimens for the treatment of adults with drug-susceptible pulmonary tuberculosis (TB). A5409 hypothesizes that novel regimens for the treatment of pulmonary tuberculosis will result in superior early efficacy, as determined by longitudinal mycobacteria growth indicator tube (MGIT) liquid culture time to positivity (TTP) measurements over the first 6 weeks of treatment, and will have acceptable safety and tolerability over 8 weeks of treatment relative to standard of care \[(SOC) isoniazid/rifampicin/pyrazinamide/ethambutol (HRZE)\]. The study will run for 52 weeks, inclusive of 26 weeks of TB treatment comprised of 8 weeks of experimental or SOC treatment (based on treatment arm assignment) followed by 18 weeks of SOC treatment with 45 participants in each experimental treatment arm and at least 90 participants in the SOC arm.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Pulmonary TB (among individuals either without history of prior TB treatment or with history of TB treatment more than 5 years prior to study entry), identified within 7 days prior to study entry by at least one sputum specimen positive for Mtb by Xpert. Semiquantitative Mtb results of medium or high are required.

• Pulmonary TB with documented INH susceptibility (by Line Probe Assay (LPA) or Xpert MTB/XDR or other validated molecular test) and with documented RIF susceptibility (by LPA or Xpert MTB/RIF or Xpert MTB/RIF Ultra or other validated molecular test) within 7 days prior to study entry.

• Documentation of HIV-1 infection status, as below:

‣ Presence or Absence of HIV-1 infection, as documented by:

• Any licensed rapid HIV test or HIV-1 enzyme or chemiluminescence immunoassay (E/CIA) test kit, any time prior to study entry. AND

⁃ Confirmed by one of the following:

• A second antibody test from different manufacturers or based on different principles and epitopes (combination antigen-antibody-based rapid tests may be used), or

∙ HIV-1 antigen, or

∙ Plasma HIV-1 RNA viral load, or

∙ A licensed Western blot

• For individuals with HIV: CD4+ cell count ≥100 cells/mm3 based on testing performed within 30 days prior to study entry.

• For individuals with HIV: Currently being treated with dolutegravir-based antiretroviral therapy (ART), or plan to initiate dolutegravir-based ART at or before study week 8.

• Individuals age ≥18 years.

• The following laboratory values obtained within 7 days prior to study entry at any network-approved non-US laboratory that operates in accordance with Good Clinical Laboratory Practices (GCLP) and participates in appropriate external quality assurance programs:

‣ Serum or plasma alanine aminotransferase (ALT) ≤3 times the upper limit of normal (ULN)

⁃ Serum or plasma total bilirubin ≤2 times ULN

⁃ Serum or plasma creatinine ≤2 times ULN

⁃ Serum or plasma potassium ≥3.5 mEq/L

⁃ Serum or plasma magnesium ≥1.0 mEq/L (≥0.500 mmol/L)

⁃ Absolute neutrophil count (ANC) ≥1500/mm\^3

⁃ Hemoglobin ≥9.5 g/dL for individuals assigned to female sex at birth and ≥10.0 g/dL for individuals assigned to male sex at birth

⁃ Platelet count ≥100,000/mm\^3

⁃ Negative for hepatitis B core antibody (HBcAb) total, hepatitis B surface antigen (HBsAg)

⁃ Negative for hepatitis C virus (HCV) antibody (or if HCV antibody positive, must have a negative HCV PCR)

• For individuals assigned to female sex at birth and who are of reproductive potential, negative pregnancy test (urine HCG or serum β-HCG) within 3 days (72 hours) prior to entry by any network-approved non-US laboratory or clinic that operates in accordance with GCLP and participates in appropriate external quality assurance programs.

• Individuals assigned to female sex at birth, who are of reproductive potential, and who participate in sexual activity that could lead to pregnancy must agree to use at least two of the following forms of birth control while receiving TB study medications and for 12 months after stopping study medications:

⁃ Male or female condoms

⁃ Diaphragm or cervical cap (with spermicide, if available)

⁃ Intrauterine device (IUD) or intrauterine system (IUS)

⁃ Hormone-based birth control (e.g., oral contraceptives, Depo-Provera, NuvaRing, implants)

• For individuals who are assigned male sex at birth who engage in sexual activity that may lead to pregnancy in their partner must agree to either remain abstinent or use male contraceptives. They are also strongly advised to inform their non-pregnant sexual partners of reproductive potential to use effective contraceptives while the individual is on study and for 90 days after experimental treatment discontinuation.

⁃ For individuals assigned male sex at birth with pregnant partners, willingness to use condoms during vaginal intercourse while on study and for 90 days after experimental treatment discontinuation.

⁃ For individuals assigned male sex at birth, willingness to refrain from sperm donation while on study and for 90 days after experimental treatment discontinuation.

⁃ Documentation of Karnofsky performance score ≥60 obtained within 14 days prior to study entry.

⁃ Chest x-ray obtained within 14 days prior to study entry.

⁃ A verifiable address or residence readily accessible for visiting, and willingness to inform the study team of any change of address during study treatment and follow-up period.

⁃ Ability and willingness of individual to provide informed consent.

Locations
Other Locations
Botswana
12701, Gaborone CRS
NOT_YET_RECRUITING
Gaborone
Brazil
12201, Hospital Nossa Senhora da Conceicao CRS
NOT_YET_RECRUITING
Porto Alegre
12101, Instituto de Pesquisa Clinica Evandro Chagas (IPEC) CRS
RECRUITING
Rio De Janeiro
Haiti
30022, Les Centres GHESKIO Clinical Research Site (GHESKIO-INLR) CRS
NOT_YET_RECRUITING
Port-au-prince
31730, GHESKIO Institute of Infectious Diseases and Reproductive Health (GHESKIO - IMIS) CRS
NOT_YET_RECRUITING
Port-au-prince
India
31441, Byramjee Jeejeebhoy Medical College (BJMC) CRS
NOT_YET_RECRUITING
Pune
Kenya
12601, Moi University Clinical Research Center (MUCRC) CRS
NOT_YET_RECRUITING
Eldoret
12501, Kenya Medical Research Institute/Walter Reed Project Clinical Research Center (KEMRI/WRP) CRS
NOT_YET_RECRUITING
Kericho
Malawi
30301, Blantyre CRS
NOT_YET_RECRUITING
Blantyre
12001, Malawi CRS
NOT_YET_RECRUITING
Lilongwe
Mexico
32078, Nutrición-Mexico CRS
NOT_YET_RECRUITING
Mexico City
Peru
11301, Barranco CRS
NOT_YET_RECRUITING
Lima
Philippines
31981, TB HIV Innovations and Clinical Research Foundation Corp.
NOT_YET_RECRUITING
Cavite
South Africa
31792, University of Cape Town Lung Institute (UCTLI) CRS
NOT_YET_RECRUITING
Cape Town
31793, South African Tuberculosis Vaccine Initiative (SATVI) CRS
RECRUITING
Cape Town
11201, Durban International CRS
NOT_YET_RECRUITING
Durban
31422, CAPRISA eThekwini CRS
NOT_YET_RECRUITING
Durban
11101, University of the Witwatersrand Helen Joseph (WITS HJH) CRS
NOT_YET_RECRUITING
Johannesburg
12301, Soweto ACTG CRS
NOT_YET_RECRUITING
Johannesburg
31684, Rustenburg CRS
RECRUITING
Rustenburg
Thailand
31784, Chiang Mai University HIV Treatment (CMU HIV Treatment) CRS
NOT_YET_RECRUITING
Chiang Mai
5116 Chiangrai Prachanukroh Hospital NICHD CRS
NOT_YET_RECRUITING
Chiang Rai
31802, Thai Red Cross AIDS Research Centre (TRC-ARC) CRS
NOT_YET_RECRUITING
Pathum Wan
Uganda
12401, Joint Clinical Research Centre (JCRC)/Kampala CRS
NOT_YET_RECRUITING
Kampala
Viet Nam
32483 National Lung Hospital CRS
NOT_YET_RECRUITING
Hanoi
Zimbabwe
30313, Milton Park CRS
NOT_YET_RECRUITING
Harare
Contact Information
Primary
Radojka Savic, PharmD, PhD
rada.savic@ucsf.edu
415-502-0640
Backup
Kelly Dooley, MD, PhD
kelly.e.dooley@vumc.org
615-322-8972
Time Frame
Start Date: 2025-03-11
Estimated Completion Date: 2027-03-11
Participants
Target number of participants: 315
Treatments
Active_comparator: Arm 1: Standard of Care (SOC)
* Weeks 1-8: INH 300 mg, RIF 600 mg, PZA weight-based, EMB weight-based~* Weeks 9-26: INH 300 mg, RIF 600 mg
Experimental: Arm 2: Bedaquiline (BDQ), Pretomanid (Pa), and Linezolid (LZD)
* Weeks 1-8: BDQ 400 mg for 2 weeks and then 200 mg for 6 weeks, Pa 200 mg, LZD 600 mg~* Weeks 9-26: INH 300 mg, RIF 600 mg
Experimental: Arm 3A: BDQ, Pa and TBI-223 (1200 mg)
* Weeks 1-8: BDQ 400 mg for 2 weeks and then 200 mg for 6 weeks, Pa 200 mg, TBI-223 1200 mg~* Weeks 9-26: INH 300 mg, RIF 600 mg
Experimental: Arm 3B: BDQ, Pa and TBI-223 (2400 mg)
* Weeks 1-8: BDQ 400 mg for 2 weeks and then 200 mg for 6 weeks, Pa 200 mg, TBI-223 2400 mg~* Weeks 9-26: INH 300 mg, RIF 600 mg
Experimental: Arm 4A: BDQ, Pa and Sutezolid (SZD) (800 mg)
* Weeks 1-8: BDQ 400 mg for 2 weeks and then 200 mg for 6 weeks, Pa 200 mg, SZD 800 mg~* Weeks 9-26: INH 300 mg, RIF 600 mg
Experimental: Arm 4B: BDQ, Pa and SZD (1600 mg)
* Weeks 1-8: BDQ 400 mg for 2 weeks and then 200 mg for 6 weeks, Pa 200 mg, SZD 1600 mg~* Weeks 9-26: INH 300 mg, RIF 600 mg
Related Therapeutic Areas
Sponsors
Leads: National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators: TB Alliance

This content was sourced from clinicaltrials.gov

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