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A Pilot Study of Methodology to Rapidly Evaluate Drugs for Bactericidal Activity, Tolerance, and Pharmacokinetics in the Treatment of Pulmonary Tuberculosis Using Isoniazid and Levofloxacin

Primary Purpose

HIV Infections, Tuberculosis

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Isoniazid
Pyridoxine hydrochloride
Levofloxacin
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Isoniazid, Tuberculosis, Pulmonary, Pyridoxine, Ofloxacin, AIDS-Related Opportunistic Infections, Drug Evaluation, Acquired Immunodeficiency Syndrome, Sputum, Colony Count, Microbial

Eligibility Criteria

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

Inclusion Criteria Concurrent Medication: Allowed in all patients: Antacids if administered more than 2 hours before or after study drug. Allowed in isoniazid patients: Anticonvulsant therapy if blood levels are monitored. Allowed in levofloxacin patients: Acceptable medications other than antacids if administered at least 2 hours before or 1 hour after study drug. Anticonvulsant therapy, theophylline, or warfarin if doses are monitored. Patients must have: Presumptive active pulmonary TB. No clinical evidence of central nervous system or miliary tuberculosis. NOTE: Both HIV-positive and HIV-negative patients are eligible. NOTE: Pregnant women may be enrolled in the isoniazid cohort only. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Active or suspected MAI infection. Active or suspected hepatitis. Any other serious acute infection, diabetes, chronic obstructive pulmonary disease, malignancy requiring chemotherapy, or major organ dysfunction. Extreme illness or toxic appearance. Pregnancy (if entering the levofloxacin portion of the study). Concurrent Medication: Excluded: All standard TB therapies. Clofazimine. Rifabutin. Quinolones. Aminoglycosides. Corticosteroids. Pentoxifylline. Colony-stimulating factors. Interferons. Interleukins. Disulfiram (patients receiving isoniazid). Patients with the following prior conditions are excluded: History of treatment-limiting intolerance or known hypersensitivity to isoniazid (in patients receiving isoniazid) or to quinolones (in patients receiving levofloxacin). Vomiting or diarrhea >= grade 2 at screening or within 2 days prior to screening. History of drug-resistant TB (in patients receiving isoniazid). Prior Medication: Excluded: Any prior treatment or prophylaxis for TB if enrolling on the isoniazid cohort. Any anti-TB drug within the past 12 weeks, including standard drugs against TB as well as clofazimine, rifabutin, and all quinolones and aminoglycosides. Corticosteroids, pentoxifylline, colony-stimulating factors, interferons, or interleukins within the past 12 weeks. Known risk factors for multi-drug resistant (MDR) TB, including: Domicile, shelter, or prison exposure to a known case of MDR TB within the past 6 months. Residence in a specific domicile, shelter, or prison cell block within 6 months of a known outbreak of MDR TB. Hospitalization, within the past 6 months, on a medical service or unit in which nosocomial transmission of MDR TB is known to have occurred.

Sites / Locations

  • Univ of Alabama at Birmingham
  • UCLA Med Ctr
  • Harbor - UCLA Med Ctr
  • Broward Gen Med Ctr
  • Univ of Miami / Jackson Memorial Hosp
  • Univ of Illinois
  • Tulane Univ Med School
  • Univ of Texas Southwestern Med Ctr of Dallas
  • Univ TX Galveston
  • Baylor College of Medicine / Houston Veterans Adm Med Ctr

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
November 2, 1999
Last Updated
August 6, 2008
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT00000778
Brief Title
A Pilot Study of Methodology to Rapidly Evaluate Drugs for Bactericidal Activity, Tolerance, and Pharmacokinetics in the Treatment of Pulmonary Tuberculosis Using Isoniazid and Levofloxacin
Official Title
A Pilot Study of Methodology to Rapidly Evaluate Drugs for Bactericidal Activity, Tolerance, and Pharmacokinetics in the Treatment of Pulmonary Tuberculosis Using Isoniazid and Levofloxacin
Study Type
Interventional

2. Study Status

Record Verification Date
June 1995
Overall Recruitment Status
Completed
Study Start Date
undefined (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
To evaluate the methodology for rapidly determining the early bactericidal activity (EBA), tolerance, and pharmacokinetics of isoniazid and levofloxacin in the treatment of pulmonary tuberculosis (TB). Traditionally, in trials for treatment of TB, a new drug is administered in combination with two or more other antituberculous agents of known effectiveness over a long period of time. In this setting, it is difficult to determine the effect of any single drug or dose level. Development of new agents for the treatment of TB may be accelerated by a methodology in which a new agent could be evaluated for activity by administering it as a single agent over a short time period. This study utilizes a method to measure the amount of bacteria present each day in the lungs.
Detailed Description
Traditionally, in trials for treatment of TB, a new drug is administered in combination with two or more other antituberculous agents of known effectiveness over a long period of time. In this setting, it is difficult to determine the effect of any single drug or dose level. Development of new agents for the treatment of TB may be accelerated by a methodology in which a new agent could be evaluated for activity by administering it as a single agent over a short time period. This study utilizes a method to measure the amount of bacteria present each day in the lungs. An initial cohort of patients receive isoniazid (with pyridoxine) daily for 5 days. Sputum samples are collected daily for determination of the EBA (decline in colony-forming units/ml sputum). If the methodology is validated, additional patients are randomized to receive one of two doses of levofloxacin daily for 5 days, with determination of EBA. All patients are hospitalized for 2 days of baseline evaluation and 5 days of treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections, Tuberculosis
Keywords
Isoniazid, Tuberculosis, Pulmonary, Pyridoxine, Ofloxacin, AIDS-Related Opportunistic Infections, Drug Evaluation, Acquired Immunodeficiency Syndrome, Sputum, Colony Count, Microbial

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Enrollment
44 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Isoniazid
Intervention Type
Drug
Intervention Name(s)
Pyridoxine hydrochloride
Intervention Type
Drug
Intervention Name(s)
Levofloxacin

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Concurrent Medication: Allowed in all patients: Antacids if administered more than 2 hours before or after study drug. Allowed in isoniazid patients: Anticonvulsant therapy if blood levels are monitored. Allowed in levofloxacin patients: Acceptable medications other than antacids if administered at least 2 hours before or 1 hour after study drug. Anticonvulsant therapy, theophylline, or warfarin if doses are monitored. Patients must have: Presumptive active pulmonary TB. No clinical evidence of central nervous system or miliary tuberculosis. NOTE: Both HIV-positive and HIV-negative patients are eligible. NOTE: Pregnant women may be enrolled in the isoniazid cohort only. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Active or suspected MAI infection. Active or suspected hepatitis. Any other serious acute infection, diabetes, chronic obstructive pulmonary disease, malignancy requiring chemotherapy, or major organ dysfunction. Extreme illness or toxic appearance. Pregnancy (if entering the levofloxacin portion of the study). Concurrent Medication: Excluded: All standard TB therapies. Clofazimine. Rifabutin. Quinolones. Aminoglycosides. Corticosteroids. Pentoxifylline. Colony-stimulating factors. Interferons. Interleukins. Disulfiram (patients receiving isoniazid). Patients with the following prior conditions are excluded: History of treatment-limiting intolerance or known hypersensitivity to isoniazid (in patients receiving isoniazid) or to quinolones (in patients receiving levofloxacin). Vomiting or diarrhea >= grade 2 at screening or within 2 days prior to screening. History of drug-resistant TB (in patients receiving isoniazid). Prior Medication: Excluded: Any prior treatment or prophylaxis for TB if enrolling on the isoniazid cohort. Any anti-TB drug within the past 12 weeks, including standard drugs against TB as well as clofazimine, rifabutin, and all quinolones and aminoglycosides. Corticosteroids, pentoxifylline, colony-stimulating factors, interferons, or interleukins within the past 12 weeks. Known risk factors for multi-drug resistant (MDR) TB, including: Domicile, shelter, or prison exposure to a known case of MDR TB within the past 6 months. Residence in a specific domicile, shelter, or prison cell block within 6 months of a known outbreak of MDR TB. Hospitalization, within the past 6 months, on a medical service or unit in which nosocomial transmission of MDR TB is known to have occurred.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hafner R
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Cohn J
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Egorin M
Official's Role
Study Chair
Facility Information:
Facility Name
Univ of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
352336505
Country
United States
Facility Name
UCLA Med Ctr
City
Los Angeles
State/Province
California
ZIP/Postal Code
900951793
Country
United States
Facility Name
Harbor - UCLA Med Ctr
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
Broward Gen Med Ctr
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33316
Country
United States
Facility Name
Univ of Miami / Jackson Memorial Hosp
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Univ of Illinois
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60622
Country
United States
Facility Name
Tulane Univ Med School
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
701122699
Country
United States
Facility Name
Univ of Texas Southwestern Med Ctr of Dallas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75235
Country
United States
Facility Name
Univ TX Galveston
City
Galveston
State/Province
Texas
ZIP/Postal Code
77550
Country
United States
Facility Name
Baylor College of Medicine / Houston Veterans Adm Med Ctr
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
Citation
El-Sadr WM, Perlman DC, Matts JP, Nelson E, Cohn D, Telzak E, Chirgwin K, Salomon N, Olibrice M, Hafner R. Outcome of an induction regimen for the treatment of HIV-related tuberculosis (TB): evaluation of the addition of a quinolone. Int Conf AIDS. 1996 Jul 7-12;11(1):327 (abstract no TuB2358)
Results Reference
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A Pilot Study of Methodology to Rapidly Evaluate Drugs for Bactericidal Activity, Tolerance, and Pharmacokinetics in the Treatment of Pulmonary Tuberculosis Using Isoniazid and Levofloxacin

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