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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Withdrawn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
Archivel Farma S.L.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tuberculosis

Eligibility Criteria

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

Inclusion Criteria:

  1. Adults (females and males) aged ≥ 18.
  2. Written informed consent in a language they understand. This includes informed consent to be in the trial and informed consent to collect specimens.
  3. 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.
  4. Patients who have not received any anti-tubercular treatment in the last 24 hours.
  5. Females of non-childbearing potential: at least 2 years post-menopausal or surgically sterile (e.g. tubal ligation).
  6. 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.
  7. 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.
  8. The patient must be willing and able to attend all study visits and comply with all study procedures.

Exclusion Criteria:

  1. Unable to provide written informed consent.
  2. Women reported, or detected, or willing to be pregnant during the trial period.
  3. Severity of illness precluding full evaluation: expected early death, evidenced by respiratory failure, low blood pressure, WHO performance score 3-4.
  4. Bodyweight < 40kg.
  5. Evidence of rifampicin resistance via GeneXpert.
  6. Unstable Diabetes Mellitus as a poor metabolic control within the past 12 months.
  7. For HIV infected subjects if the CD4+ count <250 cells/μL.
  8. 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).
  9. 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.
  10. 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).
  11. Documented allergy to TB vaccines or any of the study treatment excipients, notably, to the RUTI® vaccine.
  12. 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

    First Posted
    November 10, 2021
    Last Updated
    July 12, 2022
    Sponsor
    Archivel Farma S.L.
    Collaborators
    Fundació Institut Germans Trias i Pujol
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    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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