Evaluation of Early Bactericidal Activity in Pulmonary Tuberculosis

This study has been completed.
Sponsor:
Information provided by:
Global Alliance for TB Drug Development
ClinicalTrials.gov Identifier:
NCT01215110
First received: September 30, 2010
Last updated: October 4, 2010
Last verified: October 2010
  Purpose

The trial will evaluate the extended bactericidal activity of 14 consecutive days of oral administration of TMC207 at multiple doses as determined by the rate of change of logCFU in sputum over the time period Day 7-14 in participants with smear positive pulmonary tuberculosis (TB). A control group will receive standard treatment.


Condition Intervention Phase
Pulmonary Tuberculosis
Drug: TMC207
Drug: Rifafour e-275 mg
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Official Title: A Phase II Dose Ranging Trial to Evaluate the Extended Early Bactericidal Activity, Safety, Tolerability, and Pharmacokinetics of TMC207 in Adult Patients With Newly Diagnosed, Uncomplicated, Smear-Positive, Pulmonary Tuberculosis.

Resource links provided by NLM:


Further study details as provided by Global Alliance for TB Drug Development:

Primary Outcome Measures:
  • Extended early bactericidal activity (EBA) measured as the rate of change in log CFUs (colony forming units) in sputum. [ Time Frame: 14 days ] [ Designated as safety issue: No ]

Enrollment: 68
Study Start Date: April 2010
Study Completion Date: August 2010
Primary Completion Date: August 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: TMC207 700/500/400
TMC207- 700 mg Day 1; 500 mg Day 2; 400 mg Days 3-14
Drug: TMC207
Experimental: TMC207 500/400/300
TMC207- 500 mg Day 1; 400 mg Day 2 and 300 mg Days 3-14.
Drug: TMC207
Experimental: TMC207 400/300/200
TMC207- 400 mg Day 1; 300 mg Day 2 and 200 mg Days 3-14
Drug: TMC207
Experimental: TMC207 200/100
TMC207- 200 mg Day 1 and 100 mg Days 2-14
Drug: TMC207
Active Comparator: Rifafour e-275 mg
Rifafour e-275 mg
Drug: Rifafour e-275 mg

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Provide written, informed consent prior to all trial-related procedures including HIV testing.
  • Male or female, aged between 18 and 65 years inclusive.
  • Body weight (in light clothing and with no shoes) between 40 and 90 kg, inclusive.
  • Newly diagnosed, previously untreated, uncomplicated, sputum smear-positive, pulmonary TB.
  • A chest X-ray picture which in the opinion of the Investigator is compatible with TB.
  • Sputum positive on direct microscopy for acid-fast bacilli (at least 1+ on the IUATLD/WHO scale).
  • Ability to produce an adequate volume of sputum as estimated from a spot assessment (estimated 10 ml or more overnight production).
  • Females may participate if they are of non-childbearing potential, if they are using effective birth control methods and are willing to continue practicing birth control methods throughout treatment or if they are non-heterosexually active or willing to practice sexual abstinence throughout the treatment period or have a vasectomized partner (confirmed sterile). Therefore to be eligible for this study women of childbearing potential should either:1) use a double barrier method to prevent pregnancy (i.e. use a condom with either diaphragm or cervical cap) or 2) use hormonal based contraceptives in combination with a barrier contraceptive, or 3) use an intrauterine device in combination with a barrier contraceptive. They must also be willing to continue these contraception until 6 months after last study drug or 6 months after discontinuation from study medication in case of premature discontinuation. (Note: Hormone-based contraception may not be reliable when taking TMC207; therefore, hormone-based contraceptives cannot be used by female patients to prevent pregnancy).
  • Male patients must be willing to use a condom with spermicide when having heterosexual intercourse throughout treatment and until 1 month after last study drug administration or 1 month after discontinuation from study medication in case of premature discontinuation.

Exclusion Criteria:

  1. Evidence of clinically significant metabolic, gastrointestinal neurological, psychiatric or endocrine diseases, malignancy, or other abnormalities (other than the indication being studied).
  2. Known or suspected hypersensitivity to study medications (including any rifamycin antibiotics)
  3. Rifampicin-resistant and/or isoniazid-resistant bacteria detected with a sputum specimen collected within the pre-treatment period and tested at the study laboratory.
  4. Clinically significant evidence of extrathoracic TB (miliary TB, abdominal TB, urogenital TB, osteoarthritic TB, TB meningitis), as judged by the investigator.
  5. Current or past history of alcohol and/or drug use that, in the investigator's opinion, would compromise the participant's safety or compliance to the study protocol procedures.
  6. HIV infected patients:

    1. having a CD4+ count <300 cells/µL;
    2. or having received antiretroviral therapy medication within the last 90 days:
    3. or having received oral or intravenous antifungal medication within the last 90 days;
    4. or with an AIDS-defining opportunistic infection or malignancies (except pulmonary TB).
  7. Significant cardiac arrhythmia requiring medication
  8. Having participated in other clinical studies with investigational agents within 8 weeks prior to trial start.
  9. Patients with the following QT/QTc interval characteristics at screening:

    1. Marked prolongation of QT/QTc interval, e.g., confirmed demonstration of QTcF (Fridericia correction) interval >450 ms at screening;
    2. History of additional risk factors for Torsade de Pointes, e.g., heart failure, hypokalemia, family history of Long QT Syndrome;
    3. Use of concomitant medications that prolong the QT/QTc interval listed as disallowed medication in Section 2.10.2;
    4. Pathological Q waves (defined as >40ms or depth >0.4-0.5mV);
    5. Evidence of ventricular pre-excitation;
    6. ECG evidence of complete or incomplete left bundle branch block or right bundle branch block;
    7. Evidence of second or third degree heart block;
    8. Intraventricular conduction delay with QRS duration >120ms;
    9. Bradycardia as defined by sinus rate <50bpm
  10. Women who are pregnant or breastfeeding
  11. History and/or presence (or evidence) of neuropathy or epilepsy.
  12. Diabetics using insulin
  13. Poor general condition where any delay in treatment cannot be tolerated per discretion of Investigator.
  14. Previously received treatment with TMC207 as part of a clinical trial.
  15. Treatment received with any drug active against MTB within 3 months prior to Visit 1.
  16. Any disease or conditions in which any of the medicinal products listed in the section pertaining to prohibited medications is used.
  17. Patients with the following toxicities at screening as defined by the enhanced Division of Microbiology and Infectious Disease (DMID) adult toxicity table (November 2007):

    1. creatinine grade 2 or greater (>1.5 times upper limit of normal [ULN]);
    2. lipase grade 3 or greater (>2.0 x ULN);
    3. hemoglobin grade 4 (<6.5 g/dL) except after discussion with the Medical Monitor;
    4. aspartate aminotransferase (AST) grade 4 (>8.0 x ULN) to be excluded, grade 3 (≥3.0 x ULN) must be discussed with Medical Monitor;
    5. alanine aminotransferase (ALT) grade 4 (>8.0 x ULN) to be excluded, grade 3 (≥3.0 x ULN) must be discussed with Medical Monitor;
    6. alkaline phosphatase (ALP) grade 4 (>8.0 x ULN) to be excluded, grade 3 (≥3.0 x ULN) must be discussed with Medical Monitor;
    7. total bilirubin grade 3 or greater (>2.00 x ULN, or >1.50 x ULN when accompanied by any increase in other liver function test) to be excluded, grade 2 (>1.50 x ULN, or >1.25 x ULN when accompanied by any increase in other liver function test) must be discussed with the Medical Monitor
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01215110

Locations
South Africa
Karl Bremer Hospital
Belville, Cape Town, South Africa, 7531
Sponsors and Collaborators
Global Alliance for TB Drug Development
Investigators
Principal Investigator: Andreas Diacon TASK APPLIED SCIENCE, Karl Bremer Hospital
  More Information

No publications provided

Responsible Party: Prof. Andreas Diacon, Karl Bremner Hospital, Cape Town, South Africa
ClinicalTrials.gov Identifier: NCT01215110     History of Changes
Other Study ID Numbers: TMC207-CL001
Study First Received: September 30, 2010
Last Updated: October 4, 2010
Health Authority: United States: Institutional Review Board
South Africa: Medicines Control Council

Additional relevant MeSH terms:
Tuberculosis
Tuberculosis, Pulmonary
Mycobacterium Infections
Actinomycetales Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Lung Diseases
Respiratory Tract Diseases
Respiratory Tract Infections
Bedaquiline
Antitubercular Agents
Anti-Bacterial Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on September 22, 2014