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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT04717908
Other study ID # KY1214
Secondary ID
Status Active, not recruiting
Phase N/A
First received
Last updated
Start date January 20, 2021
Est. completion date November 30, 2023

Study information

Verified date April 2023
Source Huashan Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to assess the efficacy, safety and tolerability of a combination of bedaquiline, linezolid, cycloserine, clofazimine and pyrazinamide treatments guided by PZA sensitivity for 24 to 36 weeks in subjects with fluoroquinolone-resistant MDR-TB .


Description:

The TB-TRUST-plus is a phaseIII, multicenter, open-label trial. The purpose of this study is to assess the feasibility of the ultra-short treatment regimen guided by PZA sensitivity among fluoroquinolone-resistant MDR-TB patients.A total of 200 participants with MDR-TB will be recruited and followed up until 84 weeks after the treatment initiation. This regimen consists of two periods of 24-36 weeks. During the first 4-8 weeks(waiting for pyrazinamide drug sensitivity test), the regimen consists of bedaquiline, linezolid, cycloserine, clofazimine and pyrazinamide. Then based on molecular PZA drug sensitivity results, patients will be in divided into 3 sub-groups: pyrazinamide-susceptible (PZA-S) patients , pyrazinamide-resistant (PZA-R) patients and pyrazinamide-unavailable (PZA-U)patients. The Regimen for PZA-S patients, consisting of bedaquiline, linezolid, cycloserine and pyrazinamide, are given until the 24th week (prolonged to 28 or 32 weeks if no smear conversion by end of 16th and 20th week). PZA-R sub-group regimen, consisting of bedaquiline, linezolid, cycloserine and clofazimine ,are given until 36th week (prolonged to 40 or 44 weeks if no smear conversion by end of 16th and 20th week) . PZA-U sub-group continue the previous regimen, consisting of bedaquiline, linezolid, cycloserine , clofazimine and pyrazinamide ,until 36th week (prolonged to 40 or 44 weeks if no smear conversion by end of 16th and 20th week) . The primary objective is to access the treatment success rate without relapse of the PZA sensitivity guided ultra short regimen. The secondary objective is to access the median time to sputum culture conversion. Safety evaluations performed are the routine lab tests, blood glucose, vital signs, electrocardiograph (ECG), reporting of adverse events, peripheral neuropathy brief examining with the use of a Brief Peripheral Neuropathy rating scale(BPNS) and ophthalmologic examination, including assessment of visual acuity and color vision,physical examinations and chest CT. Adverse events will be monitored and promptly managed during the whole treatment course.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 89
Est. completion date November 30, 2023
Est. primary completion date April 30, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years to 70 Years
Eligibility Inclusion Criteria: - Willing to participate in trial treatment and follow-up and can give informed consent - 18-70 years old - Has smear-positive pulmonary tuberculosis with initial laboratory results with resistance to rifampicin and isoniazide confirmed by GeneXpert - documented resistance to fluoroquinolones at screening - Can use bedaquiline, linezolid, cycloserine, clofazimine and pyrazinamide drugs concerning the availability and costs of essential medicines - Willing to carry out HIV testing. - If the patient is a non-menopausal woman, agree to use or have used effective contraception during treatment. - Have an identifiable address and stay in the area during the study period. - Willing to follow the follow-up study procedure after the follow-up. Exclusion Criteria: - Combined extrapulmonary tuberculosis; - HIV antibody positive and AIDS patients; - Critically ill patients, and according to the judgment of the research physician, it is impossible to survive for more than 16 weeks; - Known to be pregnant or breastfeeding; - Unable to attend or follow treatment or follow-up time; - Can not take oral medications; - Patients with impaired liver function (hepatic encephalopathy, ascites; total bilirubin is more than 2 times higher than the upper limit of normal; ALT or AST is more than 5 times the upper limit of normal); - Blood muscle spasm is more than 1.5 times the upper limit of normal; - The investigator believes that there are any social or medical conditions that expose the subject to a safety hazard; - Simultaneously apply the drugs (glucocorticoids, interferons) that affect the efficacy of this study; and apply the following drugs contraindicated with the study drug, including non-steroidal anti-inflammatory drugs, monoamine oxidase inhibitors (phenethyl hydrazine, different Carbofurs et al), direct or indirect sympathomimetic drugs (such as pseudoephedrine), vasopressor drugs (such as adrenaline, norepinephrine), dopamine drugs (such as dopamine, dobutamine), 5 a serotonin reuptake inhibitor, a tricyclic antidepressant, a serotonin 5-HTI receptor antagonist (amitriptyline), meperidine or buspirone. - Being allergic or intolerant of any study drug; - Currently participating in another drug clinical trial; - QTc interval = 500 milliseconds during screening; - Hemoglobin is less than 90g/L or platelet is less than 75*10^9/L; - Have epilepsy, severe depression, irritability or psychosis; - Alcohol abuse(drinking more than 64g of ethanol a day for male, 42g for female). - Subjects receive more than 2 weeks of bedaquiline, linezolid, cycloserine, clofazimine or pyrazinamide 3 months prior to enrolment.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Bedaquiline
400 mg once daily for 2 weeks then 200mg 3 times per week;
Pyrazinamide
1500 mg daily
Linezolid
600 mg daily
Cycloserine
=50kg 500 mg daily, >50kg 750mg daily;
Clofazimine
100 mg daily;

Locations

Country Name City State
China Baoshan People's Hospital Baoshan Yunnan
China Hunan Chest Hospital Changsha Hunan
China Guiyang Public Health Treatment Center Guizhou Guizhou
China Hangzhou Red Cross Hospital Hangzhou Zhejiang
China Huaihua first people's Hospital Huaihua Hunan
China Yunnan Provincial Infectious Disease Hospital Kunming Yunnan
China Jiangxi Chest Hospital Nanchang
China Hwa Mei Hosptal,University of Chinese Academy of Sciences(Ningbo No.2 Hospital) Ningbo Zhejiang
China Huashan Hospital of Fudan University Shanghai Shanghai
China The Third People's Hospital of Shenzhen City Shenzhen Guangzhou
China Taizhou Enze medical center Enze Hospital Taizhou Zhejiang
China Chest Hospitalof Xinjiang Uygur Autonomous Region of PRC Urumqi Xinjiang
China The Central Hospital of Wenzhou City Wenzhou Zhejiang
China Shanxi Provincial Tuberculosis Control Institute Xi'an Shanxi
China The Sixth People's Hospital of Zhengzhou Zhengzhou Henan

Sponsors (1)

Lead Sponsor Collaborator
Huashan Hospital

Country where clinical trial is conducted

China, 

Outcome

Type Measure Description Time frame Safety issue
Primary Treatment success rate To access the treatment success rate without relapse .Treatment outcomes will be classified into favourable outcome and unfavourable outcome. 84 weeks after the treatment initiation
Secondary The median time to Sputum Culture Conversion time from treatment initiation to the first of two consecutive negative sputum cultures without an intervening positive culture in liquid media Time Frame: 12-36 weeks after treatment initiation
Secondary The frequency of grade 3 or greater adverse events among patients to access the proportion of patients who experience grade 3 or greater adverse events (graded according to the Division of AIDS severity criteria for adverse events) during treatment or follow-up; 84 weeks after treatment initiation
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