Adjunct Immunotherapy With Immunoxel in Patients With TB and TB/HIV

NCT01061593 | Completed Phase 3

• 1 other identifier: LRTBD-2259
• Study Type: interventional
• Target: 269
• Locations: 2 countries
• Sites: 2

Brief Summary

Dzherelo (Immunoxel) is an oral immunomodulating botanical agent available over-the-counter in Ukraine. After many years of laboratory and clinical testing the formulation was approved in 1997 by the Ministry of Health of Ukraine as a dietary herbal supplement, which enhances immunity against viral and infectious diseases. The goal of this study is to conduct confirmatory clinical trial in Ukraine and Mongolia for TB indications.

Conditions

Tuberculosis; HIV

Keywords

TB; MDR-TB; XDR-TB; TB/HIV

Outcome Measures

Primary Outcomes (1)

• To compare the efficacy of combination of Immunoxel with anti-TB treatment versus anti-TB treatment with placebo in adults with sputum smear positive pulmonary tuberculosis

  1 month

Secondary Outcomes (1)

• To confirm the safety of Immunoxel as demonstrated by Liver functions tests (ALT and bilirubin) and hemoglobin; effect on TB-associated wasting by measuring body weight. Effect on lymphocytes and CD4+ cells, CD4/CD8 ratio among those who have HIV.

  1 month

Study Arms (2)

ATT+Immunoxel

EXPERIMENTAL

TB patients with DS-TB, MDR-TB, XDR-TB or TB-HIV on standard ATT + Immunoxel honey lozenge once per day day

Dietary Supplement: Immunoxel

ATT+Placebo

PLACEBO COMPARATOR

TB patients with DS-TB, MDR-TB, XDR-TB or TB-HIV on standard ATT + Placebo lozenge made of corn syrup once/day

Other: Placebo

Interventions

Immunoxel DIETARY_SUPPLEMENT

1 lozenge once per day

Also known as: Immunoxel honey lozenges

ATT+Immunoxel

Placebo OTHER

1 lozenge once per day

Also known as: Placebo lozenge

ATT+Placebo

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Subjects who are at least 18 years and are willing and capable of providing informed consent. Both men and non-pregnant women will be included. One group of at least 30 patients will have HIV. Another group of at least 30 patients will have MDR-TB. Another group of at least 30 patients will have XDR-TB Remaining patients will have drug-sensitive TB. They will be randomly assigned to placebo at 1:1 ratio.
• TB infection documented prior to Study Entry by sputum smear positive staining for acid-fast bacilli (AFB).
• Agreement to participate in the study and to give a sample of blood for HIV testing if required.
• Readily available home or other address where patient can be easily found at follow-up studies.

You may not qualify if:

• Subjects who have taken anti-retroviral drugs or immunomodulatory therapies within 2 months prior to Entry: systemic corticosteroids, immune globulin (IV gamma globulin, IVIG), interferons, interleukins, pentoxifylline (Trental), thalidomide, filgrastim (G-CSF), sargramostim (GM-CSF); dinitrochlorobenzene (DNCB), thymosin alpha 1 (thymosin alpha), thymopentin, inosiplex (Isoprinosine), polyribonucleoside (Ampligen), ditiocarb sodium (Imuthiol), any locally available immune modulators, and any other therapeutic or preventive vaccine. Subjects requiring concurrent participation in another experimental research treatment study, or who received an experimental agent within four weeks prior to Study Entry.
• History of angina, cardiac arrhythmias, clinically significant electrocardiogram abnormalities, or congestive heart failure. Evidence of active or acute cardiac disease, concomitant hypertension, epilepsy, or serious forms of extra-pulmonary tuberculosis.
• History of malignancy, other than minimal Kaposi sarcoma or other localized skin cancer (e.g. \<10 cutaneous lesions, no evidence of visceral KS, etc.), or who have had prior cancer chemotherapy.
• Medical conditions that in the opinion of the local investigator, may obscure the proper observation of the safety or activity of the study treatment; including any acute medical condition of unknown etiology or recent surgery prior to Entry.
• Medical conditions such as active alcohol or substance abuse, or psychological issues that in the opinion of the local investigator, would interfere with adherence to the requirements of this study.

Sponsors & Collaborators

• Lisichansk Regional Tuberculosis Dispensary: lead
• Ekomed LLC: collaborator

Study Sites (2)

Misheel Lung surgery hospital,

Ulaanbaatar, Ulaanbaatar, 21000, Mongolia

Location

Kharkiv Medical National University

Kharkiv, Ukraine, 60071, Ukraine

Location

Related Publications (3)

• Efremenko YV, Arjanova OV, Prihoda ND, Yurchenko LV, Sokolenko NI, Mospan IV, Pylypchuk VS, Rowe J, Jirathitikal V, Bourinbaiar AS, Kutsyna GA. Clinical validation of sublingual formulations of Immunoxel (Dzherelo) as an adjuvant immunotherapy in treatment of TB patients. Immunotherapy. 2012 Mar;4(3):273-82. doi: 10.2217/imt.11.176.

  PMID: 22401633 RESULT

• Bourinbaiar AS, Mezentseva MV, Butov DA, Nyasulu PS, Efremenko YV, Jirathitikal V, Mishchenko VV, Kutsyna GA. Immune approaches in tuberculosis therapy: a brief overview. Expert Rev Anti Infect Ther. 2012 Mar;10(3):381-9. doi: 10.1586/eri.12.1.

  PMID: 22397570 RESULT

• Batbold U, Butov DO, Kutsyna GA, Damdinpurev N, Grinishina EA, Mijiddorj O, Kovolev ME, Baasanjav K, Butova TS, Sandagdorj M, Batbold O, Tseveendorj A, Chunt E, Zaitzeva SI, Stepanenko HL, Makeeva NI, Mospan IV, Pylypchuk VS, Rowe JL, Nyasulu P, Jirathitikal V, Bain AI, Tarakanovskaya MG, Bourinbaiar AS. Double-blind, placebo-controlled, 1:1 randomized Phase III clinical trial of Immunoxel honey lozenges as an adjunct immunotherapy in 269 patients with pulmonary tuberculosis. Immunotherapy. 2017 Jan;9(1):13-24. doi: 10.2217/imt-2016-0079. Epub 2016 Nov 21.

  PMID: 27868466 DERIVED

Related Links

• Enhancement of efficacy of tuberculosis drugs with Immunoxel (Dzherelo) in HIV-infected patients with active pulmonary tuberculosis.
• Changes in CD4+ T-cells and HIV RNA resulting from combination of anti-TB therapy with Dzherelo in TB/HIV dually infected patients.
• Effect of Immunomodulating Adjuvant Dzherelo (Immunoxel) in HIV Infected Patients Receiving Standard Antiretroviral Therapy.
• Synthetic and natural immunomodulators acting as interferon inducers.
• Cytokine profiles of HIV patients with pulmonary tuberculosis resulting from adjunct immunotherapy with herbal phytoconcentrates Dzherelo and Anemin.

MeSH Terms

Conditions

Tuberculosis; Tuberculosis, Multidrug-Resistant; Extensively Drug-Resistant Tuberculosis

Condition Hierarchy (Ancestors)

Mycobacterium Infections; Actinomycetales Infections; Gram-Positive Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Infections

Study Officials

• Galyna kutsyna, MD, PhD

  Ekomed LLC

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PI

Study Record Dates

• First Submitted: February 2, 2010
• First Posted: February 3, 2010
• Study Start: January 1, 2010
• Primary Completion: March 1, 2015
• Study Completion: April 1, 2015
• Last Updated: May 20, 2015

Record last verified: 2015-05

Locations

UA (1); MO (1)