A Phase III Study of Oral Sudapyridine (WX-081) Tablets in Rifampicin-Resistant Pulmonary Tuberculosis Patients (WISH)

A Multicenter, Randomized, Double-Blind, Active-Controlled Phase III Clinical Study to Evaluate the Efficacy and Safety of Oral Sudapyridine (WX-081) Tablets in Patients With Rifampicin-Resistant Pulmonary Tuberculosis

This is a multicenter, randomized, double-blind, active-controlled Phase III study to evaluate the efficacy and safety of Sudapyridine (WX-081) combined with a background regimen (BR) in patients with rifampicin-resistant pulmonary tuberculosis.

Approximately 450 participants will be screened over a period of up to 2 weeks and randomized in a 2:1 ratio to receive either Sudapyridine or bedaquiline, in combination with placebo tablets and BR, for 24 weeks. After the treatment period, participants will enter a background regimen period up to Week 72, during which they will continue to receive BR.

A subset of participants will be included in the C-QT sub-study to assess intensive PK sampling and 12-lead ECG evaluations on Day 1 pre-dose, Day 14, and Week 24.

The study aims to provide robust data to support the use of Sudapyridine as a treatment option for rifampicin-resistant pulmonary tuberculosis.

Study Overview

• Status: Recruiting
• Conditions: Rifampin-Resistant Pulmonary Tuberculosis; Tuberculosis, Multidrug-Resistant (MDR-TB)
• Intervention / Treatment: Drug: Sudapyridine; Drug: Bedaquiline

Detailed Description

This Phase III clinical study is designed to evaluate the efficacy and safety of Sudapyridine (WX-081) in combination with a background regimen (BR) for the treatment of rifampicin-resistant pulmonary tuberculosis. The study will be conducted at multiple centers, employing a randomized, double-blind, active-controlled design.

The study will consist of three phases:

Screening Phase:

Duration: Up to 2 weeks. Approximately 450 participants with rifampicin-resistant pulmonary tuberculosis will be screened for eligibility.

Treatment Phase:

Participants will be randomized in a 2:1 ratio into two groups:

1. Sudapyridine Group: Sudapyridine (WX-081) with placebo and BR.
2. Bedaquiline Group: Bedaquiline with placebo and BR. Treatment duration: 24 weeks.

Background Regimen Phase:

After completing the treatment phase, participants in both groups will continue to receive the background regimen (BR) until Week 72.

The study aims to test the hypothesis that Sudapyridine (WX-081), when combined with a background regimen, is effective and safe for treating rifampicin-resistant pulmonary tuberculosis. The data collected from this study will include primary and secondary endpoints related to efficacy and safety, PK/PD data, and cardiac safety evaluations.

The sample size of approximately 450 participants is designed to provide adequate power to detect a statistically significant difference in outcomes between treatment groups. Comprehensive data validation procedures and a robust statistical analysis plan will ensure the reliability and accuracy of the results.

• Study Type: Interventional
• Enrollment (Estimated): 450
• Phase: Phase 3

Contacts and Locations

• Study Contact: Name: Naihui Chu, MD; Phone Number: 010-89509312; Email: dongchu1994@sina.com
• Study Contact Backup: Name: Zhao Jie, Ph.D; Phone Number: 86010-89509157; Email: jiaojie_zhao@126.com

Study Locations

• China
  • Beijing
    • Beijing, Beijing, China, 101149
      • Recruiting
      • Beijing Chest Hospital, Capital Medical University
      • Contact: Chu Nai Hui, M.D; Phone Number: +86-010-89509312; Email: dongchu@sina.com
    • Beijing, Beijing, China, 101149
      • Enrolling by invitation
      • Beijing Chest Hospital Affiliated to Capital Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• • Body mass index (BMI) and body weight of subjects: 15.0≤BMI≤28.0 kg/m2, and 40kg≤ body weight ≤90kg;

  • For clinically diagnosed patients with tuberculosis whose drug sensitivity test has proved to be at least resistant to rifampicin, phenotypic or molecular drug sensitivity test results within 3 months before the subject signs informed consent can be accepted;
  • Direct sputum smear positive for acid-fast bacilli (AFB at least 1+);
  • Willing to discontinue all previous anti-tuberculosis drugs and accept a 7-day washout period;
  • Non-lactating and pregnant women who agree to use contraception throughout the treatment; Or the male patient's spouse agrees to use contraception throughout the treatment.

Exclusion Criteria:

• • Allergic to any study drug or its ingredients;

  • A history of alcohol dependence or drug abuse;
  • With hematogenous disseminated pulmonary tuberculosis or extrapulmonary tuberculosis;
  • Drug susceptibility test before screening showed resistance to more than 4 of the 8 antituberculosis drugs in this study;
  • Have taken Bedaquiline before;
  • HIV-positive patients;
  • Laboratory obvious abnormalities;
  • A history of pointy torsion ventricular tachycardia or cardiac risk factors for pointy torsion ventricular tachycardia;
  • Repeated QTcF intervals > 450ms; Clinically significant ventricular arrhythmias that may require medical or surgical treatment;
  • Documented cardiovascular diseases;
  • Peripheral neuropathy CTCAE grade 3 or grade 4; Grade 1 or grade 2 neuropathy that the investigator believes is likely to progress/worsen over the course of the study; optic neuritis;
  • Any serious cardiovascular, kidney, liver, blood, tumor, endocrine and metabolic, autoimmune or rheumatic diseases.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Sudapyridine (WX-081) Group; Participants in this group will receive Sudapyridine (WX-081) combined with background regimen (BR). Treatment starts with a loading dose of Sudapyridine for 2 weeks (450 mg once daily for 7 days, followed by 300 mg once daily for 7 days). This is followed by a maintenance dose of 150 mg once daily from Week 3 to Week 24. During the 24-week treatment period, participants will also receive a placebo for bedaquiline and continue their background regimen (BR). After the 24-week treatment period, participants will enter the background regimen phase and continue BR until Week 72.	Drug: Sudapyridine; Sudapyridine (WX-081) will be administered as a loading dose for 2 weeks (450 mg once daily for 7 days, followed by 300 mg once daily for 7 days) and a maintenance dose (150 mg once daily) from Week 3 to Week 24. The intervention is combined with background regimen (BR) and placebo for bedaquiline.; Other Names: WX-081
Active Comparator: Bedaquiline Group; Participants in this group will receive Bedaquiline combined with background regimen (BR). Treatment starts with a loading dose of Bedaquiline for 2 weeks (400 mg once daily), followed by a maintenance dose of 200 mg three times per week (with at least 48 hours between doses) from Week 3 to Week 24. During the 24-week treatment period, participants will also receive a placebo for Sudapyridine and continue their background regimen (BR). After the 24-week treatment period, participants will enter the background regimen phase and continue BR until Week 72.	Drug: Bedaquiline; Bedaquiline will be administered as a loading dose for 2 weeks (400 mg once daily) and a maintenance dose (200 mg three times per week, with at least 48 hours between doses) from Week 3 to Week 24. The intervention is combined with background regimen (BR) and placebo for Sudapyridine.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sputum Culture Conversion Rate at Week 24	Proportion of participants achieving sputum culture conversion (SCC) at Week 24 of treatment, measured as a percentage.	Week 24

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to Sputum Culture Conversion	Time required for participants to achieve sputum culture conversion (SCC) during the study period.	Up to Week 72
Treatment Success Rate at Week 72	Proportion of participants achieving treatment success at Week 72, based on predefined criteria.	Week 72
Sputum Culture Conversion Rates at Multiple Time Points	Proportion of participants achieving sputum culture conversion at Weeks 8, 12, 16, 20, 36, 48, 60, and 72.	Up to Week 72

Collaborators and Investigators

• Sponsor: Shanghai Jiatan Pharmatech Co., Ltd
• Investigators: Principal Investigator: Naihui Chu, Ph.D, Beijing Chest Hospital Affiliated to Capital Medical University

Study record dates

Study Major Dates

• Study Start (Actual): September 2, 2022
• Primary Completion (Estimated): December 22, 2025
• Study Completion (Estimated): October 22, 2026

Study Registration Dates

• First Submitted: April 10, 2023
• First Submitted That Met QC Criteria: April 21, 2023
• First Posted (Actual): April 24, 2023

Study Record Updates

• Last Update Posted (Actual): June 29, 2025
• Last Update Submitted That Met QC Criteria: June 25, 2025
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: Randomized Controlled Trial; Pulmonary Tuberculosis; Antitubercular Agents; Bedaquiline; Rifampin-Resistant Tuberculosis; Multidrug-Resistant Tuberculosis (MDR-TB); Sudapyridine (WX-081); Background Regimen Therapy
• Additional Relevant MeSH Terms: Respiratory Tract Infections; Infections; Respiratory Tract Diseases; Lung Diseases; Gram-Positive Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Actinomycetales Infections; Mycobacterium Infections; Tuberculosis; Tuberculosis, Pulmonary; Tuberculosis, Multidrug-Resistant; Anti-Bacterial Agents; Anti-Infective Agents; Antitubercular Agents; Bedaquiline
• Other Study ID Numbers: JYP0081M301

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No