NCT04260477

Brief Summary

To determine if a high-dose first-line regimen is non-inferior (non-inferiority margin 10%) in terms of safety to the same regimen at regular dosing, in previously treated patients with rifampicin-susceptible recurrent Tuberculosis (TB).

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
370

participants targeted

Target at P50-P75 for phase_3

Timeline
Completed

Started Mar 2021

Typical duration for phase_3

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 3, 2020

Completed
4 days until next milestone

First Posted

Study publicly available on registry

February 7, 2020

Completed
1.1 years until next milestone

Study Start

First participant enrolled

March 1, 2021

Completed
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2025

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2025

Completed
Last Updated

April 13, 2025

Status Verified

April 1, 2025

Enrollment Period

4.3 years

First QC Date

February 3, 2020

Last Update Submit

April 10, 2025

Conditions

Keywords

rifampicin-susceptible-TBTuberculosisfirst-lineTB relapseTB treatment failurehigh dose retreatment

Outcome Measures

Primary Outcomes (3)

  • STAGE 1:number of patients with any grade 3-5 Adverse Event (AE) during treatment, assessed as probably or definitely related to TB treatment

    18 months

  • STAGE 2: Describe bacterial effectiveness

    for stage 2 participants of the trial

    18 months

  • STAGE 2: Describe acquired resistance

    for stage 2 participants of the trial

    18 months

Secondary Outcomes (17)

  • STAGE 1: number of previously treated patients with H-monoresistance and H-polyresistance, rifampicin (RMP) resistance missed by Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF)

    18 months

  • STAGE 1: Programmatical effectiveness:number of participants with treatment success divided by number of participants with failure, death, or Lost to follow-up (LTFU)

    6 months, 18 months

  • STAGE 1: Clinical effectiveness: number of participants with treatment success, divided by number of participants with failure or death

    6 months, 18 months

  • STAGE 1:Bacteriological effectiveness : number of participants with treatment success, divided by number of participants with failure

    6 months, 18 months

  • STAGE 2:Bacteriological effectiveness : number of participants with treatment success, divided by number of participants with failure

    6 months, 18 months

  • +12 more secondary outcomes

Study Arms (2)

6EH³R3Z

EXPERIMENTAL

(Rifampicin (R)/ Isoniazid (H) / Pyrazinamide (Z)/Ethambutol (E)) 6-month high-dose treatment; New high-dose isoniazid / high-dose rifampicin retreatment regimen (6EH³R3Z) - that includes triple-dose rifampicin (R3; 30 mg/kg), and triple-dose isoniazid (H3; 15 mg/kg), complemented with pyrazinamide (Z) and ethambutol (E).

Drug: 6EH³R³Z

6EHRZ

ACTIVE COMPARATOR

Standard of care: 6-month 6RHZE regimen with dose combination tablets (one tablet: 150 mg R + 75 mg H + 400 mg Z + 275mg E)

Drug: 6EHRZ

Interventions

A triple dose is defined as the triple of the routine dose used for a specific WHO weight band. Hence, the mg/kg within a weigh-band varies, as is the case in routine practice. Dosing takings into consideration the fixed dose combination (FDC) tablets (one tablet: 150 mg R + 75 mg H + 400 mg Z + 275mg E). Dosage relies on tables with dosage by weight-bands used by WHO for the Cat. 1 regimen. The dosage used for the intensive phase of the Cat. 1 regimen applies for the whole treatment duration. A double dose of H and R is added to the recommended normal dose for adults (WHO,2003)

Also known as: Ethambutol; isoniazid; rifampicin; pyrazinamide, triple dose isoniazid, triple dose rifampicin
6EH³R3Z
6EHRZDRUG

Recommended normal dose adults (WHO, 2003) * H: 5 (4-6) mg/kg/day * R: 10 (8-12) mg/kg/day * Z: 25 (20-30)mg/kg/day * E: 15 (15-18)mg/kg/day

Also known as: Ethambutol; isoniazid; rifampicin; pyrazinamide
6EHRZ

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • All newly registered patients with smear-positive recurrent pulmonary TB
  • Adults as well as children (no age limit)
  • Able and willing to provide written informed consent
  • Added for stage 2: lives within 5 km of a health facility with a medical doctor

You may not qualify if:

  • All patients with TB initially resistant to rifampicin on Xpert MTB/RIF testing
  • Patients transferred to a health facility not supported by the Damien Foundation
  • Patients previously enrolled in the trial, and with another episode of rifampicin-susceptible TB during the study period
  • Those with grade III elevation of liver function tests at baseline, or with clinically active liver disease at screening
  • Pregnant or breastfeeding woman
  • HIV co-infected patients requiring treatment with a protease inhibitor

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Damien Foundation

Niamey, Niger

RECRUITING

MeSH Terms

Conditions

Tuberculosis, Multidrug-ResistantTuberculosis, PulmonaryTuberculosis

Interventions

EthambutolIsoniazidRifampinPyrazinamide

Condition Hierarchy (Ancestors)

Mycobacterium InfectionsActinomycetales InfectionsGram-Positive Bacterial InfectionsBacterial InfectionsBacterial Infections and MycosesInfectionsRespiratory Tract InfectionsLung DiseasesRespiratory Tract Diseases

Intervention Hierarchy (Ancestors)

EthylenediaminesDiaminesPolyaminesAminesOrganic ChemicalsHydrazinesIsonicotinic AcidsAcids, HeterocyclicHeterocyclic CompoundsPyridinesHeterocyclic Compounds, 1-RingRifamycinsHeterocyclic Compounds, 4 or More RingsHeterocyclic Compounds, Fused-RingLactams, MacrocyclicMacrocyclic CompoundsPolycyclic CompoundsPyrazines

Study Officials

  • Sani Kadri

    Ministry of Health, Niger

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Natacha Herssens, MSc

CONTACT

Tom Decroo, MD

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Masking Details
Providers in the TB clinics and lab technicians in the Niger clinics and labs will not be blinded to the prescribed regimen. However, lab technicians working in the Institute of Tropical Medicine (ITM) lab will be blinded to the prescribed regimen. Also the statistician will be blinded to the prescribed regimen until the first interim analysis is completed.
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 3, 2020

First Posted

February 7, 2020

Study Start

March 1, 2021

Primary Completion

June 1, 2025

Study Completion

September 1, 2025

Last Updated

April 13, 2025

Record last verified: 2025-04

Data Sharing

IPD Sharing
Will not share

Locations