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Evaluation of Early Bactericidal Activity in Pulmonary Tuberculosis (CL-010)

Primary Purpose

Pulmonary Tuberculosis

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
PA-824
PA-824
PA-824
Rifafour e-275 mg
PA-824
Sponsored by
Global Alliance for TB Drug Development
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Tuberculosis focused on measuring Early Bactericidal Activity, EBA, Pulmonary Tuberculosis, PA-824, pretomanid

Eligibility Criteria

18 Years - 64 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Informed Consent
  • Body weight between 40 and 90 kg, inclusive.
  • Newly diagnosed, previously untreated, uncomplicated, sputum smear-positive, pulmonary TB.
  • A chest X-ray compatible with TB.
  • Sputum positive
  • Adequate volume of sputum
  • Female participants of childbearing potential negative serum pregnancy and agree to use birth control
  • Male participants must agree to use contraception throughout participation in the trial and for 12 weeks after last dose.

Exclusion Criteria:

  • Poor general condition
  • Rifampicin-resistant and/or Isoniazid-resistant
  • MTB Treatment received within the 3 months prior
  • Allergy to the IMP or related substances
  • Evidence of extrathoracic TB
  • A history of previous TB
  • Evidence of serious lung conditions other than TB or uncontrolled obstructive bronchial disease
  • History of lens opacity or evidence of lens opacity on slit lamp ophthalmologic examination
  • Any evidence of renal impairment
  • For males, any evidence or history of abnormality in the reproductive system
  • History and/or presence (or evidence) of neuropathy or epilepsy.
  • Clinically relevant changes in the ECG
  • A history of or current clinically relevant cardiovascular disorder
  • Concomitant use of any drug known to prolong QTc interval
  • Diabetics using insulin
  • Evidence of clinically significant metabolic, gastrointestinal, neurological, psychiatric or endocrine diseases, malignancy, or other abnormalities (other than the indication being studied).
  • Any diseases or conditions in which the use of the standard TB drugs or any of their components is contra-indicated, including but not limited to allergy to any TB drug, their component or to the IMP.
  • Any disease or conditions in which any of the medicinal products listed in the section pertaining to prohibited medication is used.
  • alcohol or drug abuse
  • Administration of an IMP prior to Visit 1, within 5 half-lives for that IMP if known. If the half-life of the IMP is unknown within 1 month.
  • Pregnant, breast-feeding, or planning to conceive or father a child within twelve weeks of cessation of treatment for males and within one week of cessation of treatment for females.
  • Use of any drugs or substances within 30 days prior to dosing known to be strong inhibitors or inducers of cytochrome P450 enzymes
  • Any therapeutic agents known to alter any major organ function (e.g., barbiturates, opiates, phenothiazines, cimetidine) within 30 days prior to dosing.
  • glucocorticoids within one year prior to dosing.
  • HIV infection with helper/inducer T lymphocyte (CD4 cell) count of less than or equal to 300x10-6/L.
  • Receiving antiretroviral therapy (ART).

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Active Comparator

    Arm Label

    PA-824 50 mg/qd

    PA-824 100mg/qd

    PA-824 150mg/qd

    PA-824 200mg/qd

    Rifafour e-275mg

    Arm Description

    Outcomes

    Primary Outcome Measures

    Early Bactericidal Activity (EBA) Measured as the Mean Rate of Reduction of log10 Colony Forming Units (CFU) of M. Tuberculosis Per ml Sputum on Solid Medium Over Time (Days 0-14).

    Secondary Outcome Measures

    Early Bactericidal Activity (EBA) Measured as the Mean Rate of Reduction of log10 Colony Forming Units (CFU) of M. Tuberculosis Per ml Sputum on Solid Medium Over Time (Days 0-2).
    Early Bactericidal Activity (EBA) Measured as the Mean Rate of Reduction of log10 Colony Forming Units (CFU) of M. Tuberculosis Per ml Sputum on Solid Medium Over Time (Days 2-14).
    Rate of Change in Increased Time to Sputum Culture Positivity (TTP)(Hours) in Liquid Culture Media (Days 0-14).
    Rate of Change in Increased Time to Sputum Culture Positivity (TTP)(Hours) in Liquid Culture Media (Days 0-2).
    Rate of Change in Increased Time to Sputum Culture Positivity (TTP)(Hours) in Liquid Culture Media (Days 2-14).
    Pharmacokinetics- Maximum Observed Plasma Concentration (Cmax) (Day 1).
    Pharmacokinetics- Area Under the Plasma Concentration Time Curve From Zero to Infinity (AUC 0 to Infinity) (Day 1).
    Pharmacokinetics- Terminal Elimination Phase Half-life (t1/2) (Day 1).
    Pharmacokinetics-Maximum Observed Plasma Concentration (Cmax) (Day 14).
    Pharmacokinetics- Terminal Elimination Phase Half-life (t1/2) (Day 14).

    Full Information

    First Posted
    July 21, 2009
    Last Updated
    September 4, 2019
    Sponsor
    Global Alliance for TB Drug Development
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00944021
    Brief Title
    Evaluation of Early Bactericidal Activity in Pulmonary Tuberculosis (CL-010)
    Official Title
    A Phase II Dose Ranging Trial to Evaluate the Extended Early Bactericidal Activity, Safety, Tolerability, and Pharmacokinetics of PA-824 in Adult Participants With Newly Diagnosed, Uncomplicated, Smear-Positive, Pulmonary Tuberculosis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2019
    Overall Recruitment Status
    Completed
    Study Start Date
    August 2009 (undefined)
    Primary Completion Date
    January 2010 (Actual)
    Study Completion Date
    May 2010 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Global Alliance for TB Drug Development

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The trial will evaluate the extended bactericidal activity of 14 consecutive days of oral administration of PA-824 at 50, 100, 150 and 200 mg per day in adult patients with newly diagnosed, uncomplicated, smear positive tuberculosis (TB). A control group will receive standard TB treatment.
    Detailed Description
    The planned sample size of 15 participants per treatment group is in keeping with other Phase II trials of this type and accounts for the possibility of up to 3 drop-outs per arm, which based on previous studies of this type conducted at these sites, represents a conservative estimate of the expected drop-out rate.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Pulmonary Tuberculosis
    Keywords
    Early Bactericidal Activity, EBA, Pulmonary Tuberculosis, PA-824, pretomanid

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    69 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    PA-824 50 mg/qd
    Arm Type
    Experimental
    Arm Title
    PA-824 100mg/qd
    Arm Type
    Experimental
    Arm Title
    PA-824 150mg/qd
    Arm Type
    Experimental
    Arm Title
    PA-824 200mg/qd
    Arm Type
    Experimental
    Arm Title
    Rifafour e-275mg
    Arm Type
    Active Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    PA-824
    Intervention Description
    50mg
    Intervention Type
    Drug
    Intervention Name(s)
    PA-824
    Intervention Description
    100mg
    Intervention Type
    Drug
    Intervention Name(s)
    PA-824
    Intervention Description
    150 mg
    Intervention Type
    Drug
    Intervention Name(s)
    Rifafour e-275 mg
    Intervention Description
    275 mg
    Intervention Type
    Drug
    Intervention Name(s)
    PA-824
    Intervention Description
    200 mg
    Primary Outcome Measure Information:
    Title
    Early Bactericidal Activity (EBA) Measured as the Mean Rate of Reduction of log10 Colony Forming Units (CFU) of M. Tuberculosis Per ml Sputum on Solid Medium Over Time (Days 0-14).
    Time Frame
    14 consecutive days of treatment
    Secondary Outcome Measure Information:
    Title
    Early Bactericidal Activity (EBA) Measured as the Mean Rate of Reduction of log10 Colony Forming Units (CFU) of M. Tuberculosis Per ml Sputum on Solid Medium Over Time (Days 0-2).
    Time Frame
    Two consecutive days of treatment
    Title
    Early Bactericidal Activity (EBA) Measured as the Mean Rate of Reduction of log10 Colony Forming Units (CFU) of M. Tuberculosis Per ml Sputum on Solid Medium Over Time (Days 2-14).
    Time Frame
    Days 2-14 of 14 consecutive days of treatment
    Title
    Rate of Change in Increased Time to Sputum Culture Positivity (TTP)(Hours) in Liquid Culture Media (Days 0-14).
    Time Frame
    Fourteen consecutive days of treatment
    Title
    Rate of Change in Increased Time to Sputum Culture Positivity (TTP)(Hours) in Liquid Culture Media (Days 0-2).
    Time Frame
    Two consecutive days of treatment
    Title
    Rate of Change in Increased Time to Sputum Culture Positivity (TTP)(Hours) in Liquid Culture Media (Days 2-14).
    Time Frame
    Days 2-14 of 14 consecutive days of treatment
    Title
    Pharmacokinetics- Maximum Observed Plasma Concentration (Cmax) (Day 1).
    Time Frame
    0 (pre-dose), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, and 24 hours post-dose on Day 1 of treatment
    Title
    Pharmacokinetics- Area Under the Plasma Concentration Time Curve From Zero to Infinity (AUC 0 to Infinity) (Day 1).
    Time Frame
    0 (pre-dose), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, and 24 hours post-dose on Day 1 of treatment
    Title
    Pharmacokinetics- Terminal Elimination Phase Half-life (t1/2) (Day 1).
    Time Frame
    0 (pre-dose), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, and 24 hours post-dose on Day 1 of treatment
    Title
    Pharmacokinetics-Maximum Observed Plasma Concentration (Cmax) (Day 14).
    Time Frame
    0 (pre-dose), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 12,16, 24, and 30 hours post-dose on Day 14 of 14 consecutive days of treatment
    Title
    Pharmacokinetics- Terminal Elimination Phase Half-life (t1/2) (Day 14).
    Time Frame
    0 (pre-dose), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, 24 and 30 hours post-dose on Day 14 of 14 consecutive days of treatment

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    64 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Informed Consent Body weight between 40 and 90 kg, inclusive. Newly diagnosed, previously untreated, uncomplicated, sputum smear-positive, pulmonary TB. A chest X-ray compatible with TB. Sputum positive Adequate volume of sputum Female participants of childbearing potential negative serum pregnancy and agree to use birth control Male participants must agree to use contraception throughout participation in the trial and for 12 weeks after last dose. Exclusion Criteria: Poor general condition Rifampicin-resistant and/or Isoniazid-resistant MTB Treatment received within the 3 months prior Allergy to the IMP or related substances Evidence of extrathoracic TB A history of previous TB Evidence of serious lung conditions other than TB or uncontrolled obstructive bronchial disease History of lens opacity or evidence of lens opacity on slit lamp ophthalmologic examination Any evidence of renal impairment For males, any evidence or history of abnormality in the reproductive system History and/or presence (or evidence) of neuropathy or epilepsy. Clinically relevant changes in the ECG A history of or current clinically relevant cardiovascular disorder Concomitant use of any drug known to prolong QTc interval Diabetics using insulin Evidence of clinically significant metabolic, gastrointestinal, neurological, psychiatric or endocrine diseases, malignancy, or other abnormalities (other than the indication being studied). Any diseases or conditions in which the use of the standard TB drugs or any of their components is contra-indicated, including but not limited to allergy to any TB drug, their component or to the IMP. Any disease or conditions in which any of the medicinal products listed in the section pertaining to prohibited medication is used. alcohol or drug abuse Administration of an IMP prior to Visit 1, within 5 half-lives for that IMP if known. If the half-life of the IMP is unknown within 1 month. Pregnant, breast-feeding, or planning to conceive or father a child within twelve weeks of cessation of treatment for males and within one week of cessation of treatment for females. Use of any drugs or substances within 30 days prior to dosing known to be strong inhibitors or inducers of cytochrome P450 enzymes Any therapeutic agents known to alter any major organ function (e.g., barbiturates, opiates, phenothiazines, cimetidine) within 30 days prior to dosing. glucocorticoids within one year prior to dosing. HIV infection with helper/inducer T lymphocyte (CD4 cell) count of less than or equal to 300x10-6/L. Receiving antiretroviral therapy (ART).
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Andreas Diacon, MD
    Organizational Affiliation
    Karl Bremer Hospital
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Rodney Dawson, MD
    Organizational Affiliation
    University of Cape Town Lung Institute
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    22430968
    Citation
    Diacon AH, Dawson R, du Bois J, Narunsky K, Venter A, Donald PR, van Niekerk C, Erondu N, Ginsberg AM, Becker P, Spigelman MK. Phase II dose-ranging trial of the early bactericidal activity of PA-824. Antimicrob Agents Chemother. 2012 Jun;56(6):3027-31. doi: 10.1128/AAC.06125-11. Epub 2012 Mar 19.
    Results Reference
    result
    Links:
    URL
    http://www.tballiance.org/home/home.php
    Description
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