One-month Latent Tuberculosis Treatment for Renal Transplant Candidates
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Pinki J Bhatt, MD
- Phone Number: 7329392610
- Email: pb518@rwjms.rutgers.edu
Study Locations
-
-
New Jersey
-
New Brunswick, New Jersey, United States, 08901
- Pinki J Bhatt
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Men and Women Age > 18
- Weight > 30 kg
- End-stage renal disease
- Living-related or deceased kidney transplant candidate (not on the waitlist) deemed by their transplant nephrologist
- Negative serum OR urine pregnancy test
- Evidence of latent tuberculosis or high risk for tuberculosis: (1) Confirmed positive tuberculin skin test (TST) ≥ 5 mm or positive quantiferon gold test/T-spot and a chest radiograph or chest CT scan without evidence of active pulmonary TB OR (2) Patients with negative TST or quantiferon gold/T-spot test but high risk for tuberculosis are eligible if they have (i) radiographic evidence of previous TB (stable fibronodular changes, including scarring [peribronchial fibrosis, bronchiectasis, and architectural distortion] and nodular opacities in the apical and upper lung zones) and no history of adequate treatment, or (ii) have had close and prolonged contact with a case of active TB.
Exclusion Criteria:
- Age <18 years
- Absolute neutrophil count of <750 cells/mm3
- Hemoglobin < 7.4 g/dL
- Platelets < 50 x 10E3/uL
- AST (SGOT) and ALT (SGPT) > 3 times the upper limit of normal (ULN)
- Total bilirubin > 2.5 times the ULN
- Presence of active TB
- Prior history of treatment for active TB or LTBI
- Known exposure to multidrug-resistant TB
- Known history of or active porphyria
- History of liver cirrhosis
- Evidence of active acute hepatitis
- Peripheral neuropathy > grade 2
- Active drug or alcohol dependence in opinion of investigator that will interfere with adherence
- On non-modifiable medications with significant drug interactions with Rifapentine or INH
- On medications known to cause hepatoxicity and/or neutropenia
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: 1 month Rifapentine, Isoniazid and Vitamin B6
Participants will receive 28 days of self-administered daily doses of RPT, INH, and pyridoxine (vitamin B6). There are no multiple arms or multiple interventions. All participants will receive all 3 drugs. There are no comparators. |
Participants will be treated with one month (4 weeks) of daily Isoniazid, Rifapentine and Vitamin B6.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of adverse events with 1-m INH/RPT/Vit B6
Time Frame: 28 days
|
Treatment discontinuation due to adverse reaction of study drug determined by investigator
|
28 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of treatment compliance
Time Frame: 28 days
|
Percentage of daily dosage taken within the 28 day course
|
28 days
|
|
Rate of treatment completion
Time Frame: 28 days
|
Completion of 28 day course within a 5 week period
|
28 days
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of reactivation of active tuberculosis
Time Frame: 2 years
|
Rate of culture-confirmed tuberculosis disease after completing study regimen
|
2 years
|
|
Trough drug concentration
Time Frame: 28 days
|
Isoniazid and Rifapentine serum drug concentration
|
28 days
|
|
3-hour post-dose drug concentration
Time Frame: 28 days
|
Isoniazid and Rifapentine serum drug concentration
|
28 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Pinki Bhatt, MD, Rutgers
Publications and helpful links
General Publications
- Zhang T, Zhang M, Rosenthal IM, Grosset JH, Nuermberger EL. Short-course therapy with daily rifapentine in a murine model of latent tuberculosis infection. Am J Respir Crit Care Med. 2009 Dec 1;180(11):1151-7. doi: 10.1164/rccm.200905-0795OC. Epub 2009 Sep 3.
- Swindells S, Ramchandani R, Gupta A, Benson CA, Leon-Cruz J, Mwelase N, Jean Juste MA, Lama JR, Valencia J, Omoz-Oarhe A, Supparatpinyo K, Masheto G, Mohapi L, da Silva Escada RO, Mawlana S, Banda P, Severe P, Hakim J, Kanyama C, Langat D, Moran L, Andersen J, Fletcher CV, Nuermberger E, Chaisson RE; BRIEF TB/A5279 Study Team. One Month of Rifapentine plus Isoniazid to Prevent HIV-Related Tuberculosis. N Engl J Med. 2019 Mar 14;380(11):1001-1011. doi: 10.1056/NEJMoa1806808.
- Singh N, Paterson DL. Mycobacterium tuberculosis infection in solid-organ transplant recipients: impact and implications for management. Clin Infect Dis. 1998 Nov;27(5):1266-77. doi: 10.1086/514993.
- Subramanian A, Dorman S; AST Infectious Diseases Community of Practice. Mycobacterium tuberculosis in solid organ transplant recipients. Am J Transplant. 2009 Dec;9 Suppl 4:S57-62. doi: 10.1111/j.1600-6143.2009.02894.x. No abstract available.
- Adamu B, Abdu A, Abba AA, Borodo MM, Tleyjeh IM. Antibiotic prophylaxis for preventing post solid organ transplant tuberculosis. Cochrane Database Syst Rev. 2014 Mar 4;2014(3):CD008597. doi: 10.1002/14651858.CD008597.pub2.
- Agarwal SK, Gupta S, Dash SC, Bhowmik D, Tiwari SC. Prospective randomised trial of isoniazid prophylaxis in renal transplant recipient. Int Urol Nephrol. 2004;36(3):425-31. doi: 10.1007/s11255-004-6251-6.
- Rafiei N, Williams J, Mulley WR, Trauer JM, Jenkin GA, Rogers BA. Mycobacterium tuberculosis: Active disease and latent infection in a renal transplant cohort. Nephrology (Carlton). 2019 May;24(5):569-574. doi: 10.1111/nep.13386.
- van den Boogaard J, Kibiki GS, Kisanga ER, Boeree MJ, Aarnoutse RE. New drugs against tuberculosis: problems, progress, and evaluation of agents in clinical development. Antimicrob Agents Chemother. 2009 Mar;53(3):849-62. doi: 10.1128/AAC.00749-08. Epub 2008 Dec 15. No abstract available.
- Holland DP, Sanders GD, Hamilton CD, Stout JE. Potential economic viability of two proposed rifapentine-based regimens for treatment of latent tuberculosis infection. PLoS One. 2011;6(7):e22276. doi: 10.1371/journal.pone.0022276. Epub 2011 Jul 18.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
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
- Latent Infection
- Urogenital Diseases
- Pathologic Processes
- Male Urogenital Diseases
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Chronic Disease
- Disease Attributes
- Infections
- Renal Insufficiency
- Gram-Positive Bacterial Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Renal Insufficiency, Chronic
- Actinomycetales Infections
- Mycobacterium Infections
- Tuberculosis
- Pathological Conditions, Signs and Symptoms
- Kidney Failure, Chronic
- Latent Tuberculosis
- Organic Chemicals
- Pyridines
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Hydrazines
- Isonicotinic Acids
- Acids, Heterocyclic
- Picolines
- Isoniazid
- Vitamin B 6
- rifapentine
Other Study ID Numbers
Other Study ID Numbers
- Pro2018001735
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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