search
Back to results

A Phase 2 Trial to Evaluate the EBA, Safety and Tolerability of Eto Alone and in Combination With BVL-GSK098 (BETO)

Primary Purpose

Rifampicin- and Isoniazid-Susceptible Pulmonary Tuberculosis (TB)

Status
Recruiting
Phase
Phase 2
Locations
South Africa
Study Type
Interventional
Intervention
BVL-GSK098 9mg
Ethionamide 250mg
Ethionamide 250 mg
Isoniazid 300 MG
Sponsored by
TASK Applied Science
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rifampicin- and Isoniazid-Susceptible Pulmonary Tuberculosis (TB)

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

- Participants are required to meet all the following criteria in order to be randomized.

  1. Provide written, informed consent prior to all trial-related procedures.
  2. Male or female, aged between 18 and 65 years, inclusive.
  3. Body weight (in light clothing and with no shoes) between 40 and 90 kg, inclusive.
  4. Newly diagnosed and untreated pulmonary TB.
  5. Rifampicin- and isoniazid-susceptible pulmonary TB as determined by molecular testing (GeneXpert XDR or Genotype MTBDRplus for INH).
  6. A chest X-ray taken during the screening period or up to 2 weeks before screening which, in the opinion of the investigator, is consistent with TB.
  7. GeneXpert positive with a quantitative readout of medium or high.
  8. Ability to produce an adequate volume of sputum as estimated from an overnight sputum collection sample (estimated 10 ml or more).
  9. Be of non-childbearing potential or using effective methods of birth control.
  10. For WOCBP, injectable or other contraceptive methods (per Appendix 1) need to be given prior to or during screening, and at least 2 days prior to first dose of IP.

    Exclusion Criteria:

    • Participants will be excluded from participation if they fulfil any of the following criteria.

    Medical History

  11. Evidence of clinically significant conditions or findings, other than TB, that might compromise safety or the interpretation of trial endpoints, per discretion of the investigator.
  12. History of epilepsy, seizures or other neuropsychiatric disorders that might compromise safety or the interpretation of trial endpoints, per discretion of the investigator
  13. History of hypothyroidism
  14. QTcF of >450 ms at baseline
  15. Clinically significant evidence of extrathoracic TB, as judged by the investigator.
  16. History of allergy to any of the trial IP as confirmed by the clinical judgement of the investigator.
  17. Alcohol or drug abuse, that in the opinion of the investigator, is sufficient to compromise the safety or cooperation of the participant.
  18. HIV positive AND:

    1. CD4 < 250cells/mm3
    2. OR, on ART in stage 1 only. Participants established on ART (2 NRTIs and dolutegravir) for more than 30 days at start of screening are eligible for participation in stage 2.

    NOTE: ART permitted in Stage 2 is limited to the following in line with local guidelines for 1st line ART:

    • NRTIs selected from: Emtricitabine, Lamivudine, Tenofovir
    • PLUS Dolutegravir

    As the drug-drug interaction potential of ART has not been fully investigated with the IP, NNRTIs (efavirenz, nevirapine) and other protease inhibitors will not be permitted in this study.

  19. Female participant who is pregnant, breast-feeding, or planning to conceive a child within the anticipated period of trial participation. Male participant planning to conceive a child for at least 90 days, after the last dose of study intervention in the trial.

    Treatment History

  20. Participation in other clinical studies with investigational agents within 8 weeks prior to screening.
  21. Treatment received for this episode of TB with any drug active against M.tb (including but not limited to isoniazid, ethambutol, amikacin, cycloserine, fluoroquinolones, rifabutin, rifampicin, streptomycin, kanamycin, para-aminosalicylic acid, rifapentine, pyrazinamide, thioacetazone, capreomycin, thioamides).
  22. Treatment with immunosuppressive medications such as TNF-alpha inhibitors within 2 weeks prior to screening, or systemic corticosteroids for more than 7 days within 2 weeks prior to screening.

Sites / Locations

  • TASK Clinical Research CentreRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm Type

Experimental

Active Comparator

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm Description

BVL-GSK098 9 mg once daily (OD) plus ethionamide 250 mg OD (b9Eto250)

Isoniazid 300 mg po OD (INH)

BVL-GSK098 27 mg OD plus ethionamide 125 mg po OD (b27Eto125)

BVL-GSK098 27 mg OD plus ethionamide 250 mg po OD (b27Eto250)

BVL-GSK098 27 mg OD plus ethionamide 500 mg po OD (b27Eto500)

Ethionamide 250 mg po OD (Eto250)

Ethionamide 750 mg po given in a single or divided dose daily (Eto750)

Outcomes

Primary Outcome Measures

EBA CFU
The EBA CFU(0-7) as determined by the predicted rate of change in log10CFU per ml sputum over the period day 0 to day 7 will be described using linear, bi-linear or non-linear functions using nonlinear mixed effects modelling as dictated by the data of log10CFU over time and relation to drug exposure. Predicted estimate of rates of change including uncertainties for the potential differences in treatment effects between the groups will be given and graphically illustrated.

Secondary Outcome Measures

EBA TTP
The EBA TTP(0-7) as determined by the predicted rate of change in TTP over the period day 0 to day 7 will be described using linear, bi-linear or non-linear functions using nonlinear mixed effects modelling of TTP over time and relation to drug exposure.

Full Information

First Posted
July 12, 2022
Last Updated
January 17, 2023
Sponsor
TASK Applied Science
search

1. Study Identification

Unique Protocol Identification Number
NCT05473195
Brief Title
A Phase 2 Trial to Evaluate the EBA, Safety and Tolerability of Eto Alone and in Combination With BVL-GSK098
Acronym
BETO
Official Title
A Phase 2 Trial to Evaluate the EBA, Safety and Tolerability of Ethionamide Alone and in Combination With BVL-GSK098 Administered Orally to Adults With Newly Diagnosed, Rifampicin- and Isoniazid-Susceptible Pulmonary Tuberculosis
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 6, 2022 (Actual)
Primary Completion Date
October 2023 (Anticipated)
Study Completion Date
October 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
TASK Applied Science

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To evaluate the 7-day early bactericidal activity (EBA), pharmacokinetics (PK), safety and tolerability of ethionamide (Eto) with or without BVL-GSK098 in participants with rifampicin- and isoniazid-susceptible pulmonary TB.
Detailed Description
A single-centre, open-label, clinical trial in two stages. All treatments will be administered orally (PO) on days 1-7. Stage 1 will recruit 15 participants into arm 1 who will receive Eto and a low dose BVL-GSK098 combination (bEto), including 3 participants from the control arm (arm 2). Participants will be randomized 5:1. This will be followed by a recruitment pause and an interim analysis to evaluate safety of the combination. Stage 1: Arm Regimen Participants BVL-GSK098 9 mg once daily (OD) plus ethionamide 250 mg OD (b9Eto250) 15 Isoniazid 300 mg po OD (INH) 3 * BVL-GSK098 9 mg will be given 12-hourly on Day one (loading dose), then once daily on Day 2-7. An interim safety analysis will be performed after all Stage 1 participants complete the end of treatment visit (Day 8). If the b9Eto250 arm meets the predefined safety criteria (Section 9), the study will proceed to Stage 2. Recruitment will then continue with the remaining arms randomized in a 4:5:5:5:5:5 ratio. Stage 2: Arm Regimen Participants 2 Isoniazid 300 mg po OD (INH) 12 3 BVL-GSK098 27 mg OD plus ethionamide 125 mg po OD (b27Eto125) 15 4 BVL-GSK098 27 mg OD plus ethionamide 250 mg po OD (b27Eto250) 15 5 BVL-GSK098 27 mg OD plus ethionamide 500 mg po OD (b27Eto500) 15 6 Ethionamide 250 mg po OD (Eto250) 15 7 Ethionamide 750 mg po given in a single or divided dose daily (Eto750) 15 * BVL-GSK098 27 mg will be given 12-hourly on Day one (loading dose), then once daily on Day 2-7. Ethionamide 750 mg given in divided doses Day 1-3, and OD Day 4-7. Participants on INH will serve as control for the EBA quantitative mycobacteriology. The study will not be blinded but the mycobacteriology laboratory staff performing the endpoint assays will remain blinded until analysis of the EBA results.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rifampicin- and Isoniazid-Susceptible Pulmonary Tuberculosis (TB)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
A single-centre, open-label, clinical trial in two stages. All treatments will be administered orally (PO) on days 1-7.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
105 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
BVL-GSK098 9 mg once daily (OD) plus ethionamide 250 mg OD (b9Eto250)
Arm Title
Arm 2
Arm Type
Active Comparator
Arm Description
Isoniazid 300 mg po OD (INH)
Arm Title
Arm 3
Arm Type
Experimental
Arm Description
BVL-GSK098 27 mg OD plus ethionamide 125 mg po OD (b27Eto125)
Arm Title
Arm 4
Arm Type
Experimental
Arm Description
BVL-GSK098 27 mg OD plus ethionamide 250 mg po OD (b27Eto250)
Arm Title
Arm 5
Arm Type
Experimental
Arm Description
BVL-GSK098 27 mg OD plus ethionamide 500 mg po OD (b27Eto500)
Arm Title
Arm 6
Arm Type
Experimental
Arm Description
Ethionamide 250 mg po OD (Eto250)
Arm Title
Arm 7
Arm Type
Experimental
Arm Description
Ethionamide 750 mg po given in a single or divided dose daily (Eto750)
Intervention Type
Drug
Intervention Name(s)
BVL-GSK098 9mg
Other Intervention Name(s)
Ethionamide 125 and 250mg
Intervention Description
BVL-GSK098 9 mg once daily po OD plus ethionamide 250 mg po OD (b9Eto250) BVL-GSK098 27 mg OD plus ethionamide 125 mg po OD (b27Eto125 BVL-GSK098 27 mg OD plus ethionamide 250 mg po OD (b27Eto250) BVL-GSK098 27 mg OD plus ethionamide 500 mg po OD (b27Eto500)
Intervention Type
Drug
Intervention Name(s)
Ethionamide 250mg
Intervention Description
Ethionamide 250 mg po OD (Eto250)
Intervention Type
Drug
Intervention Name(s)
Ethionamide 250 mg
Other Intervention Name(s)
Ethionamide 250mg
Intervention Description
Ethionamide 750 mg po given in a single or divided dose (Eto750)
Intervention Type
Drug
Intervention Name(s)
Isoniazid 300 MG
Intervention Description
Isoniazid 300 mg po OD (INH)
Primary Outcome Measure Information:
Title
EBA CFU
Description
The EBA CFU(0-7) as determined by the predicted rate of change in log10CFU per ml sputum over the period day 0 to day 7 will be described using linear, bi-linear or non-linear functions using nonlinear mixed effects modelling as dictated by the data of log10CFU over time and relation to drug exposure. Predicted estimate of rates of change including uncertainties for the potential differences in treatment effects between the groups will be given and graphically illustrated.
Time Frame
7 days
Secondary Outcome Measure Information:
Title
EBA TTP
Description
The EBA TTP(0-7) as determined by the predicted rate of change in TTP over the period day 0 to day 7 will be described using linear, bi-linear or non-linear functions using nonlinear mixed effects modelling of TTP over time and relation to drug exposure.
Time Frame
7 days
Other Pre-specified Outcome Measures:
Title
Adverse events
Description
The incidence of the following events will be summarized by treatment group: Incidence of treatment-emergent adverse events (TEAEs); Incidence of TEAEs by Severity; Incidence of drug related TEAEs; Incidence of Serious TEAEs; Incidence of TEAEs leading to early withdrawal; Incidence of TEAEs leading to death. Descriptive summary statistics will be presented for other safety variables: laboratory parameters, physical examination, vital signs, concomitant medication.
Time Frame
7 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: - Participants are required to meet all the following criteria in order to be randomized. Provide written, informed consent prior to all trial-related procedures. 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 and untreated pulmonary TB. Rifampicin- and isoniazid-susceptible pulmonary TB as determined by molecular testing (GeneXpert XDR or Genotype MTBDRplus for INH). A chest X-ray taken during the screening period or up to 2 weeks before screening which, in the opinion of the investigator, is consistent with TB. GeneXpert positive with a quantitative readout of medium or high. Ability to produce an adequate volume of sputum as estimated from an overnight sputum collection sample (estimated 10 ml or more). Be of non-childbearing potential or using effective methods of birth control. For WOCBP, injectable or other contraceptive methods (per Appendix 1) need to be given prior to or during screening, and at least 2 days prior to first dose of IP. Exclusion Criteria: Participants will be excluded from participation if they fulfil any of the following criteria. Medical History Evidence of clinically significant conditions or findings, other than TB, that might compromise safety or the interpretation of trial endpoints, per discretion of the investigator. History of epilepsy, seizures or other neuropsychiatric disorders that might compromise safety or the interpretation of trial endpoints, per discretion of the investigator History of hypothyroidism QTcF of >450 ms at baseline Clinically significant evidence of extrathoracic TB, as judged by the investigator. History of allergy to any of the trial IP as confirmed by the clinical judgement of the investigator. Alcohol or drug abuse, that in the opinion of the investigator, is sufficient to compromise the safety or cooperation of the participant. HIV positive AND: CD4 < 250cells/mm3 OR, on ART in stage 1 only. Participants established on ART (2 NRTIs and dolutegravir) for more than 30 days at start of screening are eligible for participation in stage 2. NOTE: ART permitted in Stage 2 is limited to the following in line with local guidelines for 1st line ART: NRTIs selected from: Emtricitabine, Lamivudine, Tenofovir PLUS Dolutegravir As the drug-drug interaction potential of ART has not been fully investigated with the IP, NNRTIs (efavirenz, nevirapine) and other protease inhibitors will not be permitted in this study. Female participant who is pregnant, breast-feeding, or planning to conceive a child within the anticipated period of trial participation. Male participant planning to conceive a child for at least 90 days, after the last dose of study intervention in the trial. Treatment History Participation in other clinical studies with investigational agents within 8 weeks prior to screening. Treatment received for this episode of TB with any drug active against M.tb (including but not limited to isoniazid, ethambutol, amikacin, cycloserine, fluoroquinolones, rifabutin, rifampicin, streptomycin, kanamycin, para-aminosalicylic acid, rifapentine, pyrazinamide, thioacetazone, capreomycin, thioamides). Treatment with immunosuppressive medications such as TNF-alpha inhibitors within 2 weeks prior to screening, or systemic corticosteroids for more than 7 days within 2 weeks prior to screening.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Kim Nieuwenhout
Phone
+27211003606
Email
regulatory@task.org.za
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Veronique de Jager, MBChB
Organizational Affiliation
TASK
Official's Role
Principal Investigator
Facility Information:
Facility Name
TASK Clinical Research Centre
City
Cape Town
State/Province
Western Cape
ZIP/Postal Code
7530
Country
South Africa
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Veronique de Jager, HBChB
Phone
+27219141044
Email
dr.veronique@task.org.za

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Plan not yet available
IPD Sharing Time Frame
Immediately after publication.
IPD Sharing Access Criteria
Not available yet

Learn more about this trial

A Phase 2 Trial to Evaluate the EBA, Safety and Tolerability of Eto Alone and in Combination With BVL-GSK098

We'll reach out to this number within 24 hrs