Evaluation of Efficacy and Safety of the Concomitant of RUTI® Immunotherapy With the Standard Treatment in TB Patients (CONSTAN)
Primary Purpose
Tuberculosis
Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
RUTI® vaccine
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Tuberculosis
Eligibility Criteria
Inclusion Criteria:
- Adults (females and males) aged ≥ 18.
- Written informed consent in a language they understand. This includes informed consent to be in the trial and informed consent to collect specimens.
- Laboratory confirmed pulmonary TB (with or without extrapulmonary involvement) defined as a hard copy of a sputum laboratory result that reports Mtb detection by sputum-microscopy smear-positive at least 1+, rapid molecular assay or mycobacterial culture.
- Patients who have not received any anti-tubercular treatment in the last 24 hours.
- Females of non-childbearing potential: at least 2 years post-menopausal or surgically sterile (e.g. tubal ligation).
- Females of childbearing potential (including females less than 2 years post-menopausal) must have a negative pregnancy test at enrolment and must agree to use highly effective methods of birth control (i.e. diaphragm plus spermicide or male condom plus spermicide, oral contraceptive in combination with a second method, contraceptive implant, injectable contraceptive, indwelling intrauterine device, sexual abstinence, or a vasectomized partner) while participating in the study.
- Males must agree to use a double-barrier method of contraception (condom plus spermicide or diaphragm plus spermicide) at least 1 month after RUTI/placebo vaccination; or the male patient or his female partner must be surgically sterile (e.g. vasectomy, tubal ligation) or the female partner must be post-menopausal.
- The patient must be willing and able to attend all study visits and comply with all study procedures.
Exclusion Criteria:
- Unable to provide written informed consent.
- Women reported, or detected, or willing to be pregnant during the trial period.
- Severity of illness precluding full evaluation: expected early death, evidenced by respiratory failure, low blood pressure, WHO performance score 3-4.
- Bodyweight < 40kg.
- Evidence of rifampicin resistance via GeneXpert.
- Unstable Diabetes Mellitus as a poor metabolic control within the past 12 months.
- For HIV infected subjects if the CD4+ count <250 cells/μL.
- Major co-morbid conditions or any other finding which in the opinion of the investigator would compromise the protocol compliance or significantly influence the interpretation of results (i.e. cancer, immunodeficiency of any nature including treatment with immunosuppressant drugs and excluding HIV infection).
Any of the following laboratory parameters:
- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 3 x upper limit of normal (ULN);
- Total bilirubin > 2 x ULN;
- Neutrophil count ≤ 500 neutrophils / mm3;
- Platelet count < 50,000 platelets / mm3.
- Alcohol use: potential participant either self-reports or in the investigator's opinion that the patient drinks more than an average of four units/day over a usual week or is a binge drinker (men: 5 or more drinks; women: consume 4 or more drinks, in about 2 hours).
- Documented allergy to TB vaccines or any of the study treatment excipients, notably, to the RUTI® vaccine.
- Concurrent enrolment in another clinical study, unless it is an observational (noninterventional) clinical study or during the follow-up period of an interventional study.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Group A (RUTI)
Group B (Placebo)
Arm Description
Subjets will receive one inoculation of the RUTI® vaccine at the same time as standard treatment is started. It will be administered subcutaneously in the deltoid region at a dose of 25 µg of fragmented, purified and liposomed heat-inactivated Mycobacterium tuberculosis bacilli (FCMtb) in an injection volume of 0.3 mL
Subjets will receive one inoculation of normal saline at the same time as standard treatment is started. It will be administered subcutaneously in the deltoid region.
Outcomes
Primary Outcome Measures
Early Bactericidal Activity (EBA) from day 0 to day 14
Measured as the reduction of bacillary load of M. Tuberculosis based upon Time to detection (TTD) signal in MGIT.
Secondary Outcome Measures
Early Bactericidal Activity (EBA) from 2 to 14 days
Measured as the reduction of bacillary load of M. Tuberculosis based upon Time to detection (TTD) signal in MGIT. Difference between each intervention arm and control group.
Early Bactericidal Activity (EBA) from 7 to 14 days
Measured as the reduction of the bacillary load of M. Tuberculosis based upon Time to detection (TTD) signal in MGIT.
Early Bactericidal Activity (EBA) from 4 to 24 week
Measured as the reduction of the bacillary load of M. Tuberculosis based upon Time to detection (TTD) signal in MGIT
Hazard ratio for stable culture conversion (SCC).
Difference between each intervention arm and control group.
Rate of Change in Time to Sputum Culture Positivity (TTP) in Liquid Culture Media (Days 0-14).
Difference between each intervention arm and control group.
Rate of Change in Time to Sputum Culture Positivity (TTP) in Liquid Culture Media (week 4, 8, 16 and 24 )
Difference between each intervention arm and control group.
The proportion of patients with AEs between each intervention arm and the control group.
Difference of patients with AEs between each intervention arm and control group.
The proportion of patients with SAEs between each intervention arm and the control group
Difference of patients with SAEs between each intervention arm and control group.
Proportion of patients with CLINICAL, X-ray or LABORATORY worsening
Difference of patients with Clinical, X-ray or Laboratory worsening between each intervention arm and control group.
Proportion of patients with improvement of clinical signs and symptoms, Bandim TB score
Difference of patients with improvement of clinical signs and symptoms between intervention and control group.
Number of patients with improvement of Health-related Quality of Life (HRQoL) comparing baseline measure with that over the course of therapy.
Difference f patients with improvement of HRQoL between each intervention arm and control group.
Full Information
NCT ID
NCT05136833
First Posted
November 10, 2021
Last Updated
July 12, 2022
Sponsor
Archivel Farma S.L.
Collaborators
Fundació Institut Germans Trias i Pujol
1. Study Identification
Unique Protocol Identification Number
NCT05136833
Brief Title
Evaluation of Efficacy and Safety of the Concomitant of RUTI® Immunotherapy With the Standard Treatment in TB Patients
Acronym
CONSTAN
Official Title
A Phase IIb Study to Explore the Efficacy and Safety of the Concomitant Administration of RUTI® Immunotherapy With the Standard Treatment in Patients With TB
Study Type
Interventional
2. Study Status
Record Verification Date
July 2022
Overall Recruitment Status
Withdrawn
Why Stopped
Covid-19 pandemia
Study Start Date
December 1, 2021 (Actual)
Primary Completion Date
June 30, 2022 (Actual)
Study Completion Date
December 31, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Archivel Farma S.L.
Collaborators
Fundació Institut Germans Trias i Pujol
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
The study is an exploratory clinical trial to evaluate the efficacy and safety of the treatment with a vaccine against tuberculosis (RUTI®) given at the same time as standard treatment in patients with tuberculosis. It is a prospective, randomized (1:1), double-blind, multicentre, placebo-controlled clinical phase IIb trial.
Detailed Description
Patients will be randomized (1: 1) to receive an inoculation of RUTI® or placebo at the same time that standard treatment is started.
The standard TB treatment will continue after RUTI® or placebo administration according to SOC guidelines. All the patients will be followed up 6 months after the vaccination or until the end of SOC treatment.
Once all the patients have completed the week 2 follow-up, a Data Safety Monitoring Board (DSMB) will be established to review all relevant safety and toxicity data.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tuberculosis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Group A (RUTI)
Arm Type
Experimental
Arm Description
Subjets will receive one inoculation of the RUTI® vaccine at the same time as standard treatment is started. It will be administered subcutaneously in the deltoid region at a dose of 25 µg of fragmented, purified and liposomed heat-inactivated Mycobacterium tuberculosis bacilli (FCMtb) in an injection volume of 0.3 mL
Arm Title
Group B (Placebo)
Arm Type
Placebo Comparator
Arm Description
Subjets will receive one inoculation of normal saline at the same time as standard treatment is started. It will be administered subcutaneously in the deltoid region.
Intervention Type
Biological
Intervention Name(s)
RUTI® vaccine
Intervention Description
Each dose of the RUTI® vaccine contains 25 µg of fragmented, purified and liposomed heat-inactivated Mycobacterium tuberculosis bacilli (FCMtb) in a total volum of 0.3mL.
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
Normal saline will be used as a placebo.
Primary Outcome Measure Information:
Title
Early Bactericidal Activity (EBA) from day 0 to day 14
Description
Measured as the reduction of bacillary load of M. Tuberculosis based upon Time to detection (TTD) signal in MGIT.
Time Frame
Daily between day 0 and day 14 after treatment initiation and RUTI®/placebo vaccination.
Secondary Outcome Measure Information:
Title
Early Bactericidal Activity (EBA) from 2 to 14 days
Description
Measured as the reduction of bacillary load of M. Tuberculosis based upon Time to detection (TTD) signal in MGIT. Difference between each intervention arm and control group.
Time Frame
Daily between day 2 and day 14 after treatment initiation and RUTI®/placebo vaccination.
Title
Early Bactericidal Activity (EBA) from 7 to 14 days
Description
Measured as the reduction of the bacillary load of M. Tuberculosis based upon Time to detection (TTD) signal in MGIT.
Time Frame
Daily between day 7 and day 14 after treatment initiation and RUTI®/placebo vaccination.
Title
Early Bactericidal Activity (EBA) from 4 to 24 week
Description
Measured as the reduction of the bacillary load of M. Tuberculosis based upon Time to detection (TTD) signal in MGIT
Time Frame
At week 4, 8, 16 and 24 after treatment initiation and RUTI®/placebo vaccination
Title
Hazard ratio for stable culture conversion (SCC).
Description
Difference between each intervention arm and control group.
Time Frame
24 weeks of TB treatment
Title
Rate of Change in Time to Sputum Culture Positivity (TTP) in Liquid Culture Media (Days 0-14).
Description
Difference between each intervention arm and control group.
Time Frame
14 days
Title
Rate of Change in Time to Sputum Culture Positivity (TTP) in Liquid Culture Media (week 4, 8, 16 and 24 )
Description
Difference between each intervention arm and control group.
Time Frame
Up to week 24
Title
The proportion of patients with AEs between each intervention arm and the control group.
Description
Difference of patients with AEs between each intervention arm and control group.
Time Frame
Up to week 24
Title
The proportion of patients with SAEs between each intervention arm and the control group
Description
Difference of patients with SAEs between each intervention arm and control group.
Time Frame
Up to week 24
Title
Proportion of patients with CLINICAL, X-ray or LABORATORY worsening
Description
Difference of patients with Clinical, X-ray or Laboratory worsening between each intervention arm and control group.
Time Frame
Through study completion, an average of 24 weeks
Title
Proportion of patients with improvement of clinical signs and symptoms, Bandim TB score
Description
Difference of patients with improvement of clinical signs and symptoms between intervention and control group.
Time Frame
At weeks 2, 8, 24
Title
Number of patients with improvement of Health-related Quality of Life (HRQoL) comparing baseline measure with that over the course of therapy.
Description
Difference f patients with improvement of HRQoL between each intervention arm and control group.
Time Frame
At week 8, week 24
Other Pre-specified Outcome Measures:
Title
IFN-γ production of ex vivo stimulated peripheral blood mononuclear cells (PBMC) (Exploratory endpoint for immunogenicity outcomes 1)
Description
Immunogenic properties of the intervention group will be compared to the control group assessed by the evaluation of IFN-γ production of specific immune cells.
Time Frame
Up to week 24
Title
The summative ability of PBMCs to control mycobacterial growth inhibition assay (MGIA) (Exploratory endpoint for immunogenicity outcomes 2)
Description
Immunogenic properties of the intervention group will be compared to the control group assessed by the summative ability of specific immune cells to control mycobacterial growth inhibition.
Time Frame
Up to week 24
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Adults (females and males) aged ≥ 18.
Written informed consent in a language they understand. This includes informed consent to be in the trial and informed consent to collect specimens.
Laboratory confirmed pulmonary TB (with or without extrapulmonary involvement) defined as a hard copy of a sputum laboratory result that reports Mtb detection by sputum-microscopy smear-positive at least 1+, rapid molecular assay or mycobacterial culture.
Patients who have not received any anti-tubercular treatment in the last 24 hours.
Females of non-childbearing potential: at least 2 years post-menopausal or surgically sterile (e.g. tubal ligation).
Females of childbearing potential (including females less than 2 years post-menopausal) must have a negative pregnancy test at enrolment and must agree to use highly effective methods of birth control (i.e. diaphragm plus spermicide or male condom plus spermicide, oral contraceptive in combination with a second method, contraceptive implant, injectable contraceptive, indwelling intrauterine device, sexual abstinence, or a vasectomized partner) while participating in the study.
Males must agree to use a double-barrier method of contraception (condom plus spermicide or diaphragm plus spermicide) at least 1 month after RUTI/placebo vaccination; or the male patient or his female partner must be surgically sterile (e.g. vasectomy, tubal ligation) or the female partner must be post-menopausal.
The patient must be willing and able to attend all study visits and comply with all study procedures.
Exclusion Criteria:
Unable to provide written informed consent.
Women reported, or detected, or willing to be pregnant during the trial period.
Severity of illness precluding full evaluation: expected early death, evidenced by respiratory failure, low blood pressure, WHO performance score 3-4.
Bodyweight < 40kg.
Evidence of rifampicin resistance via GeneXpert.
Unstable Diabetes Mellitus as a poor metabolic control within the past 12 months.
For HIV infected subjects if the CD4+ count <250 cells/μL.
Major co-morbid conditions or any other finding which in the opinion of the investigator would compromise the protocol compliance or significantly influence the interpretation of results (i.e. cancer, immunodeficiency of any nature including treatment with immunosuppressant drugs and excluding HIV infection).
Any of the following laboratory parameters:
Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 3 x upper limit of normal (ULN);
Total bilirubin > 2 x ULN;
Neutrophil count ≤ 500 neutrophils / mm3;
Platelet count < 50,000 platelets / mm3.
Alcohol use: potential participant either self-reports or in the investigator's opinion that the patient drinks more than an average of four units/day over a usual week or is a binge drinker (men: 5 or more drinks; women: consume 4 or more drinks, in about 2 hours).
Documented allergy to TB vaccines or any of the study treatment excipients, notably, to the RUTI® vaccine.
Concurrent enrolment in another clinical study, unless it is an observational (noninterventional) clinical study or during the follow-up period of an interventional study.
12. IPD Sharing Statement
Learn more about this trial
Evaluation of Efficacy and Safety of the Concomitant of RUTI® Immunotherapy With the Standard Treatment in TB Patients
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