Tuberculous Meningitis Clinical Trial
Official title:
A Pilot Phase II Randomized Controlled Double Blind Trial of 81mg Aspirin Daily vs. 1000 mg Aspirin Daily vs. Placebo as Adjunctive Therapy in HIV Negative Adults With Tuberculous Meningitis
Tuberculous meningitis is a severe brain infection which often causes disability and death even when treated with the best available treatment. Aspirin is a type of anti-inflammation drug which can reduce the inflammatory response in brains of patients with tuberculous meningitis, and therefore may decrease some of the most severe outcomes. This study compares the use of aspirin (at 2 different doses) versus placebo as an additional therapy to the standard treatment to see if aspirin is safe and helpful in reducing disability and death from tuberculous meningitis. Patients will be treated with aspirin or placebo for 60 days and followed up while on standard treatment for 8 months.
The study is a parallel group, double blind, randomised, placebo controlled trial of 60 days
treatment with placebo vs. 81mg daily dose vs. 1000mg daily dose aspirin for the treatment
of HIV-uninfected adults with tuberculous meningitis.
All patients will receive standard anti-tuberculous chemotherapy and adjunctive
dexamethasone, according to Viet Nam National Tuberculosis Programme guidelines.
Participants will be stratified by Medical Research Council UK disease severity grade, and
randomized at enrollment to one of three study arms (1:1:1 ratio). Patients will be admitted
to hospital for at least the first 14 days of study treatment enabling real-time active
surveillance of any adverse events after which they will be discharged according to clinical
care with continued monitoring.
A schedule of clinical and laboratory monitoring including lumbar puncture, pharmacokinetic
assessment of peripheral blood monocyte/macrophage antimicrobial activity, clinical
assessments, brain magnetic resonance imaging (MRI) and neurological assessment will manage
patient safety and capture study outcomes.
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