Pulmonary tuberculosis
Conditions
Interventions
Trade Name: Priftin
Product Name: RIFAPENTINE
Pharmaceutical Form: Tablet
INN or Proposed INN: RIFAPENTINE
CAS Number: 61379-65-5
Concentration unit: mg milligram(s)
Concentration type: equal
Concentr
Sponsors
Unidad de investigación en Tuberculosis de Barcelona
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: A. Suspected pulmonary tuberculosis plus one or both of the following: a) at least one sputum specimen positive for acid-fast bacilli on smear microscopy OR b) at least one sputum specimen positive for M. tuberculosis by Xpert MTB/RIF testing, with semiquantitative result of ?medium? or ?high? and rifamycin resistance not detected. B. Age twelve (12) years or older C. A verifiable address or residence location that is readily accessible for visiting, and willingness to inform the study team of any change of address during the treatment and follow-up period. D. Women of child-bearing potential who are not surgically sterilized must agree to practice an adequate method of contraception (barrier method or non-hormonal intrauterine device) or abstain from heterosexual intercourse during study drug treatment. E. Documentation of HIV infection status. F. For HIV-positive individuals, CD4 T cell count greater than or equal to 100 cells/mm3 based on testing performed at or within 30 days prior to study entry. HIV-positive individuals will be enrolled in a staged approach as described in Section 8.3.10.1, specifically: ? Group 1 (?EFV1?): receipt of efavirenz-based antiretroviral therapy (ART) for a minimum of 30 days at the time of enrollment AND a documented HIV viral load less than 200 copies/mL at or within 30 days prior to study entry, OR ? Group 2 (?EFV2?): for HIV-positive individuals not on ART at enrollment, planned initiation of efavirenz-based ART before or at study week 8 G. Laboratory parameters done at or within 14 days prior to screening: ? Serum or plasma alanine aminotransferase (ALT) less than or equal to 3 times the upper limit of normal ? Serum or plasma total bilirubin less than or equal to 2.5 times the upper limit of normal ? Serum or plasma creatinine level less than or equal to 2 times the upper limit of normal ? Serum or plasma potassium level greater than or equal to 3.5 meq/L ? Hemoglobin level of 7.0 g/dL or greater ? Platelet count of 100,000/mm3 or greater H. For all women who are not surgically sterilized or who do not meet the study definition of post-menopausal, a negative pregnancy test at or within seven (7) days prior to screening I. Karnofsky score greater than or equal to 60 J. Written informed consent Are the trial subjects under 18? yes Number of subjects for this age range: 100 F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 2000 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 400
Exclusion criteria
Exclusion criteria: A. Pregnant or breast-feeding B. Unable to take oral medications C. Previously enrolled in this study D. Received any investigational drug in the past 3 months E. More than five (5) days of treatment directed against active tuberculosis within 6 months preceding initiation of study drugs F. More than five (5) days of systemic treatment with any one or more of the following drugs within 30 days preceding initiation of study drugs: isoniazid, rifampin, rifabutin, rifapentine, ethambutol, pyrazinamide, kanamycin, amikacin, streptomycin, capreomycin, moxifloxacin, levofloxacin, gatifloxacin, ofloxacin, ciprofloxacin, other fluoroquinolones, ethionamide, prothionamide, cycloserine, terizidone, para-aminosalicylic acid, linezolid, clofazimine, delamanid or bedaquiline G. Known history of prolonged QT syndrome H. Suspected or documented tuberculosis involving the central nervous system and/or bones and/or joints, and/or miliary tuberculosis and/or pericardial tuberculosis I. Current or planned use within six months following enrollment of one or more of the following medications: HIV protease inhibitors, HIV integrase inhibitors, HIV entry and fusion inhibitors, HIV non-nucleoside reverse transcriptase inhibitors other than efavirenz; quinidine, procainamide, amiodarone, sotalol, disopyramide, ziprasidone, or terfenadine. J. Weight less than 40.0 kg K. Known allergy or intolerance to any of the study medications L. Individuals will be excluded from enrollment if, at the time of enrollment, their M. tuberculosis isolate is already known to be resistant to any one or more of the following: rifampin, isoniazid, pyrazinamide, ethambutol, or fluoroquinolones. M. Other medical conditions, that, in the investigator?s judgment, make study participation not in the individual?s best interest. N. Current or planned incarceration or other involuntary detention.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: ? To evaluate the efficacy of a rifapentine-containing regimen to determine whether the single substitution of rifapentine for rifampin makes it possible to reduce to seventeen weeks the duration of treatment for drug-susceptible pulmonary tuberculosis ? To evaluate the efficacy of a rifapentine-containing regimen that in addition substitutes moxifloxacin for ethambutol and continues moxifloxacin during the continuation phase to determine whether it is possible to reduce to seventeen weeks the duration of treatment for drug-susceptible pulmonary tuberculosis;Secondary Objective: ? To evaluate the safety of the investigational regimens ? To evaluate the tolerability of the investigational regimens ? To collect and assess biospecimens from consenting participants for the purpose of research on discovery and validation of TB biomarkers ? To determine the correlation of mycobacterial and clinical markers with time to culture conversion, culture status at completion of eight weeks of treatment, treatment failure, and relapse. ? To conduct a pharmacokinetic/pharmacodynamic (PK/PD) study of the test drugs. The main objectives of the PK/PD study are to characterize study drug PK parameters and to determine relationships between treatment outcomes and PK parameters. ? To evaluate the pharmacokinetics of efavirenz-based antiretroviral treatment among patients with TB/HIV co-infection taking efavirenz-based combination antiretroviral therapy and TB treatment with rifapentine;Primary end point(s): ? Efficacy: TB disease-free survival at twelve months after study treatment assignment. ? Safety: Proportion of participants with grade 3 or higher adverse events during study drug treatment;Timepoint(s) of evaluation of this end point: Twelve months after study treatment | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): ? TB disease-free survival at eighteen months after study treatment assignment ? Time to stable sputum culture conversion (solid and liquid media considered separately) ? Speed of decline of sputum viable bacilli by automated liquid MGIT culture days to detection ? Proportion of participants who are culture negative at completion of eight weeks of treatment (solid and liquid media considered separately) ? Sensitivity analyses assuming all participants classified as ?not assessable? have a favorable outcome ? Discontinuation of assigned treatment for a reason other than microbiological ineligibility ? Estimated steady state efavirenz PK parameters including mid-dosing interval concentration;Timepoint(s) of evaluation of this end point: Eighteen months after study treatment | — |
Countries
Hong Kong, Kenya, Peru, South Africa, Spain, Uganda, United States, Vietnam
Contacts
Public ContactJoan A. Caylà
Unidad de investigación en Tuberculosis de Barcelona
Outcome results
None listed