EVALUATING NEWLY APPROVED DRUGS IN COMBINATION REGIMENS FOR MULTIDRUG-RESISTANT TB WITH FLUOROQUINOLONE RESISTANCE (Q)
- Conditions
- -A15 Respiratory tuberculosis, bacteriologically and histologically confirmedRespiratory tuberculosis, bacteriologically and histologically confirmedA15
- Registration Number
- PER-020-20
- Lead Sponsor
- MEDICOS SIN FRONTERAS FRANCIA,
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- Not specified
- Target Recruitment
- 0
A patient will be eligible for randomization if s/he:
1.Has documented pulmonary tuberculosis due to strains of M. tuberculosis resistant to rifampin (RIF) and not susceptible to fluoroquinolones, according to a validated rapid molecular test.
2.Is ≥15 years of age;
3.Is willing to use effective contraception: pre-menopausal women or women whose last menstrual period was within the preceding year, who have not been sterilized must agree to use two methods of contraception (e.g., a hormonal method and a barrier method) unless their partner has had a vasectomy; men who have not had a vasectomy must agree to use condoms;
4.Provides informed consent for study participation; additionally a legal representative of patients considered minor per local laws should also provide consent;
5.Lives in a dwelling that can be located by study staff and expects to remain in the area for the duration of the study.
A patient will not be eligible for randomization if s/he:
1.Has known allergies or hypersensitivity to any of the investigational drugs;
2.Is known to be pregnant or is unwilling or unable to stop breastfeeding an infant;
3.Is unable to comply with treatment or follow-up schedule;
4.Has any condition (social or medical) which, in the opinion of the site principal investigator, would make study participant unsafe;
5.a. Has had exposure (intake of the drug for 30 days or more) in the past five years to bedaquiline, delamanid, linezolid, or clofazimine, or has proven or likely resistance to bedaquiline, delamanid, linezolid, or clofazimine (e.g., household contact of a DR-TB index case who died or experienced treatment failure after treatment containing bedaquiline, delamanid, linezolid, or clofazimine or had resistance to one of the listed drugs); exposure to other anti-TB drugs is not a reason for exclusion.
b. Has received second-line drugs for 15 days or more prior to screening visit date in the current MDR/RR-TB treatment episode. Exceptions include: (1) patients whose treatment has failed according to the WHO definition(175) and who are being considered for a new treatment regimen; (2) patients starting a new treatment regimen after having been lost to follow-up” according to the WHO definition(175) and, (3) patients in whom treatment failure is suspected (but not confirmed according to WHO definition), who are being considered for a new treatment regimen, and for whom the Clinical Advisory Committee (CAC) consultation establishes eligibility.
6.Has one or more of the following:
•Hemoglobin ≤7.9 g/dL;
•Uncorrectable electrolytes disorders:
Total Calcium <7.0 mg/dL (1.75 mmol/L);
Potassium <3.0 mEq/L (3.0 mmol/L) or ≥6.0 mEq/L (6.0 mmol/L);
Magnesium <0.9 mEq/L (0.45 mmol/L);
•Serum creatinine >3 x ULN;
•Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT) ≥3 x ULN;
•Total bilirubin ≥3 x ULN;
•Albumin <2.8 g/dL;
•Unless otherwise specified, Grade 4 result as defined by the MSF Severity Scale (Appendix 2) on any of the screening laboratory tests.
7.Has cardiac risk factors defined as:
•An arithmetic average of the two ECGs with highest QTcF intervals of greater than or equal to 450 ms. Retesting to reassess eligibility will be allowed using an unscheduled visit during the screening phase;
•Evidence of ventricular pre-excitation (e.g., Wolff Parkinson White syndrome);
•Electrocardiographic evidence of either:
oComplete left bundle branch block or right bundle branch block; OR
oIncomplete left bundle branch block or right bundle branch block and QRS complex duration >120 msec on at least one ECG;
•Having a pacemaker implant;
•Congestive heart failure;
•Evidence of second or third degree heart block;
•Bradycardia as defined by sinus rate less than 50 bpm;
•Personal or family history of Long QT Syndrome;
•Personal history of arrhythmic cardiac disease, with the exception of sinus arrhythmia;
•Personal history of syncope (i.e. cardiac syncope not including syncope due to vasovagal or epileptic causes).
8.Is currently taking part in another trial of a medicinal product;
9.Is taking any medication that is contraindicated with the medicines in the trial regimen which cannot be stopped (with or without replacement) or req
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method <br>Outcome name:A participant’s outcome will be classified as favorable at Week 73 if the outcome is not classified as unfavorable, and one of the following is true:<br>•The last two culture results are negative. These two cultures must be taken from sputum samples collected on separate visits, the latest between Week 65 and Week 73;<br>•The last culture result (from a sputum sample collected between Week 65 and Week 73) is negative; and either there is no other post-baseline culture result or the penultimate culture result is positive due to laboratory cross contamination; and bacteriological, radiological and clinical evolution is favorable;<br>•There is no culture result from a sputum sample collected between Week 65 and Week 73 or the result of that culture is positive due to laboratory cross contamination; and the most recent culture result is negative; and bacteriological, radiological and clinical evolution is favorable.<br><br>Measure:Efficacy<br>Timepoints:Week 73<br>
- Secondary Outcome Measures
Name Time Method