Short Course Rifapentine and Isoniazid for the Preventive Treatment for Latent Genital Tuberculosis (SCRIPT-LGTB)
Role of Short Course Rifapentine and Isoniazid for the Preventive Treatment for Latent Genital Tuberculosis in Women With Recurrent Implantation Failure: A Prospective Interventional Cohort Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The prevalence of latent genital tuberculosis (LGTB) is relatively high in women with infertility and recurrent pregnancy loss. Whether preventive treatment of latent tuberculosis infection (LTBI) can improve the fertility outcome in women with recurrent implantation failure (RIF) remains to be explored.
This is a prospective interventional cohort study.The main purpose of this study is to compare the fertility outcome between 1-month regimen of three times weekly rifapentine plus isoniazid and no treatment in RIF patients with LGTB and RIF patients without LGTB. The study will also assess the safety and tolerability and the efficacy of the preventive treatment regimen in prevention of the incidence of active female genital tuberculosis (FGTB).
A total of 1050 participants will be recruited for screening of LGTB. The endometrial tuberculosis (TB) polymerase chain reaction (PCR) test will be employed for the diagnosis of LGTB. Eligible participants with negative TB PCR results will be assigned to the non-LGTB group, while those with positive TB PCR results will be assigned to the LGTB group. The LGTB group will be further assigned, according to their will to receive preventive treatment of tuberculosis, to one of the following groups: the LGTB treatment group and the LGTB no treatment group.
The LGTB treatment group will receive the 1-month regimen of three times weekly rifapentine plus isoniazid, and the in vitro fertilization (IVF)/ intra cytoplasmic sperm injection (ICSI) cycle can be started after 1 month post the completion of the treatment regimen. Adverse events and side effects will be monitored at a 2-week interval during the preventive treatment and followed up once more at 4 weeks post the end of treatment. The LGTB no treatment group and the non-LGTB group will start the IVF/ICSI cycle directly after enrollment without taking any medication related to preventive treatment of tuberculosis.
Eligible participants will be followed up until the end of an IVF/ ICSI cycle or pregnancy. Fertility outcomes of both groups will be recorded and compared. Secondary outcomes, including the incidence of adverse events, the adhesion of treatment and the incidence of LGTB and FGTB, ovarian reserve, embryo quality, history of infertility and tuberculosis will also be recorded and compared.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
Shanghai
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Shanghai, Shanghai, China, 200051
- Shanghai First Maternity and Infant Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Women aged 25-40 years old
- Infertile women failed to achieve clinical pregnancy after 4 good quality embryo transfers, with at least 3 fresh or frozen IVF cycles
- Intended to undergo IVF/ICSI
- Ultrasonography or hysterosalpingogram showed a normal uterus cavity, and the thickness of the endometrium was ≥8mm before implantation during last IVF/ICSI cycle
- Patients who voluntarily signed the informed consent and agreed to be followed up as required by the study protocol
Exclusion Criteria:
- Use of donor eggs/sperm
- An abnormal uterine cavity shown on hysterosalpingogram or hysteroscopy
- Proven tubal infertility
- Proven preimplantation genetic abnormality
- Proven active tuberculosis
- Treated for active tuberculosis or used preventive treatment for LTBI within 2 years
- Being allergic or intolerant of any study drug
- HIV antibody positive and AIDS patients
- Patients with impaired liver function: hepatic encephalopathy, ascites; total bilirubin is more than 2 times higher than the upper limit of normal; alanine transaminase (ALT) or aspartate aminotransferase (AST) is more than 5 times the upper limit of normal
- Patients with diabetes mellitus
- Critically ill patients, and according to the judgment of the research physician, it is impossible to survive for more than 16 weeks
- Currently participating in another drug clinical trial
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: LGTB treatment group
The LGTB treatment group will receive the 1-month regimen of three times weekly rifapentine (150mg per capsule, 450mg po tiw) plus isoniazid (100mg per tablet, 400mg po tiw).
|
receive the 1-month regimen of three times weekly rifapentine (450mg po) plus isoniazid (400mg po)
|
|
No Intervention: LGTB no treatment group
The LGTB no treatment group will not take any medication related to preventive treatment of tuberculosis.
|
|
|
No Intervention: non-LGTB group
The non-LGTB group will not take any medication related to preventive treatment of tuberculosis.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Clinical pregnancy rates
Time Frame: 6 weeks after completion of an IVF/ICSI cycle
|
Clinical pregnancy was defined as the presence of at least one gestational sac on ultrasound at 6 weeks.
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6 weeks after completion of an IVF/ICSI cycle
|
|
Ongoing Pregnancy Rate
Time Frame: 10 weeks after completion of an IVF/ICSI cycle
|
Ongoing pregnancy was the presence of at least one foetus with heart pulsation on ultrasound beyond 10 weeks.
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10 weeks after completion of an IVF/ICSI cycle
|
|
Miscarriage rate
Time Frame: 22 weeks after completion of an IVF/ICSI cycle
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The number of miscarriages before 22 weeks divided by the number of participants with positive pregnancy test.
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22 weeks after completion of an IVF/ICSI cycle
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Implantation rate
Time Frame: 6 weeks after completion of an IVF/ICSI cycle
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The number of gestational sacs seen on scanning divided by the number of embryos replaced.
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6 weeks after completion of an IVF/ICSI cycle
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|
Incidence of LGTB
Time Frame: 4 weeks after enrollment
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The number of participants diagnosed with LGTB devided by the number of participants screened for LGTB.
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4 weeks after enrollment
|
|
Incidence of FGTB
Time Frame: 2 years
|
The number of participants developed FGTB during treatment or follow-up devided by the number of participants in the LGTB treatment group.
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2 years
|
|
Incidence of grade 3 or greater adverse events
Time Frame: 20 weeks after preventive treatment initiated
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The number of participants reported grade 3 or greater adverse events during treatment or follow-up devided by the number of participants in the LGTB treatment group.
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20 weeks after preventive treatment initiated
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Completion rate of preventive treatment
Time Frame: 20 weeks after preventive treatment initiated
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11 or 12 doses of the 1-month preventive treatment regimen of three times weekly rifapentine plus isoniazid taken within 16 weeks after treatment initiated will be regarded as completion of preventive treatment.
The number of participants completed treatment devided by the number of participants initiated the preventive treatment.
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20 weeks after preventive treatment initiated
|
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Discontinuation of treatment
Time Frame: 20 weeks after preventive treatment initiated
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The number of participants discontinued treatment devided by the number of participants in the LGTB treatment group.
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20 weeks after preventive treatment initiated
|
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Discontinuation of treatment due to side effect of study drugs
Time Frame: 20 weeks after preventive treatment initiated
|
The number of participants discontinued treatment due to side effect of study drugs devided by the number of participants in the LGTB treatment group.
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20 weeks after preventive treatment initiated
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
General Publications
- Grace GA, Devaleenal DB, Natrajan M. Genital tuberculosis in females. Indian J Med Res. 2017 Apr;145(4):425-436. doi: 10.4103/ijmr.IJMR_1550_15.
- Jindal UN, Verma S, Bala Y. Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis. Hum Reprod. 2012 May;27(5):1368-74. doi: 10.1093/humrep/des076. Epub 2012 Mar 14.
- Dam P, Shirazee HH, Goswami SK, Ghosh S, Ganesh A, Chaudhury K, Chakravarty B. Role of latent genital tuberculosis in repeated IVF failure in the Indian clinical setting. Gynecol Obstet Invest. 2006;61(4):223-7. doi: 10.1159/000091498. Epub 2006 Feb 13.
- Jirge PR, Chougule SM, Keni A, Kumar S, Modi D. Latent genital tuberculosis adversely affects the ovarian reserve in infertile women. Hum Reprod. 2018 Jul 1;33(7):1262-1269. doi: 10.1093/humrep/dey117.
- Bagchi B, Chatterjee S, Gon Chowdhury R. Role of latent female genital tuberculosis in recurrent early pregnancy loss: A retrospective analysis. Int J Reprod Biomed. 2019 Dec 30;17(12):929-934. doi: 10.18502/ijrm.v17i12.5799. eCollection 2019 Dec.
Study record dates
Study Major Dates
Study Start (Anticipated)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Gram-Positive Bacterial Infections
- Actinomycetales Infections
- Mycobacterium Infections
- Latent Infection
- Tuberculosis, Urogenital
- Infertility
- Tuberculosis
- Latent Tuberculosis
- Infertility, Female
- Tuberculosis, Female Genital
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antimetabolites
- Hypolipidemic Agents
- Lipid Regulating Agents
- Anti-Bacterial Agents
- Leprostatic Agents
- Antitubercular Agents
- Antibiotics, Antitubercular
- Fatty Acid Synthesis Inhibitors
- Rifapentine
- Isoniazid
Other Study ID Numbers
Other Study ID Numbers
- KS20232
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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