Re-evaluating the Duration in Children of TB Treatment (REDUCE TB)
Multi-arm, Open-label, Duration-randomized, Phase IIc Study of the Efficacy, Safety, Tolerability, and Pharmacokinetics of Optimized Rifampicin in Combination With Isoniazid, Pyrazinamide, and Ethambutol for the Treatment of Children With Drug-susceptible Tuberculosis
Current tuberculosis (TB) treatment is effective (works well), but it takes a long time to cure TB. This study will evaluate if TB treatment with a higher dose of rifampicin, one of the TB medicines, and shorter TB treatment duration is as effective and safe as the standard, TB treatment (with the usual rifampicin dose and usual duration). This study hopes to find a better shorter treatment that works as well as the current treatment (standard of care). This could benefit children worldwide who are getting TB treatment.
Children 3 months to less than 10 years of age who have drug-susceptible TB (can be successfully treated with standard TB medicines) are eligible for this study.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
This is a multi-arm open-label phase IIc trial with duration randomization, with a lead-in pharmacokinetics (PK) study. Children 3 months to less than 10 years of age with routinely diagnosed clinical or confirmed drug-susceptible TB will be screened and if eligible randomly assigned 1:1:1:1:1 to one of five arms (durations of TB treatment and control arm). Randomization will be stratified by age (3 months to less than 5 years of age vs 5 to less than 10 years of age).
A total of 200 participants will be enrolled in the main trial (Step 2), with 40 per study arm, with an additional 30 participants enrolled in a Lead-in PK study (Step 1).
Step 1 - Lead-in PK study participants will be on treatment for 8 weeks, complete their trial participation in up to 9 weeks, and will not contribute to the main trial endpoints.
Step 2 - Main trial participants will be on study for 48 weeks.
Primary Objective:
In children with drug-susceptible tuberculosis, with and without HIV:
• To characterize the relationship between treatment duration of the experimental regimen and the proportion of participants with unfavorable treatment outcome at 48 weeks after randomization (i.e., the duration-response curve)
Secondary Objectives:
The secondary objectives of the Lead-In PK study are to
- Characterize the safety and tolerability of two optimized doses of rifampicin with standard doses of isoniazid, pyrazinamide and ethambutol
- Characterize the pharmacokinetics of two optimized doses of rifampicin
- Characterize the acceptability of two optimized doses of rifampicin
The secondary objectives of the Main Study are to:
- Characterize the safety and tolerability of optimized-dose rifampicin with standard doses of isoniazid, pyrazinamide and ethambutol
- Characterize the pharmacokinetics of optimized-dose rifampicin
- Characterize lung health post-TB treatment at week 48 among children able to complete lung-health assessments
- Characterize the acceptability of optimized-dose rifampicin
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: UW Clinical Trials Institute
- Telefonnummer: 608.265.3132
- E-mail: info@clinicaltrials.wisc.edu
Studiesteder
-
-
-
Lima, Peru
- Socios en Salud Sucursal Peru
-
Ledende efterforsker:
- Leonid Lecca, MD
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- 3 months to less than 10 years of age
- Body weight greater than or equal to 3 kilograms (kg) and less than 45 kg at study entry
Confirmed or clinically diagnosed intrathoracic (pulmonary) and/or some forms of extrathoracic (extrapulmonary) drug-susceptible TB:
Confirmed intrathoracic (pulmonary) TB, based on chest radiograph and/or symptoms consistent with TB, and/or some forms of extrathoracic TB, with all of the following as determined by the site investigator:
- Microbiological confirmation of M. tuberculosis from any clinical specimen by either culture or molecular methods
- At least rifampicin-susceptibility demonstrated by genotypic (molecular) or phenotypic methods
- Documented clinical decision to treat for drug-susceptible TB
Clinically diagnosed intrathoracic (pulmonary) TB, based on chest radiograph and/or symptoms consistent with TB, and/or some forms of extrathoracic TB, with all of the following as determined by the site investigator:
- Documented clinical decision to treat for drug-susceptible TB
- HIV positive or negative
- For participants living with HIV, they must be on a dolutegravir-based antiretroviral therapy regimen at the time of study entry
Exclusion Criteria:
- Received routine treatment for TB disease for greater than 5 days at the time of enrollment
- Exposure to a case of intrathoracic TB in the 12 months prior to enrollment with known or suspected resistance to any of the drugs in the treatment regimens OR confirmed resistance on molecular or phenotypic drug-susceptibility testing to any drugs in the treatment regimens
- Has greater than or equal to grade 3 results of any of the following during screening: creatinine, serum ALT, AST, total bilirubin
- Has hemoglobin less than 7.5 g/dL during screening
- Has TB meningitis, osteoarticular TB, or miliary TB as determined by the site investigator
- Severe renal, pulmonary, cardiac, gastrointestinal, neurologic or any other condition that in the judgement of the investigator would make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving study objectives
- Use of any prohibited drug within 3 days of enrollment
- Severe acute malnutrition defined as weight-for-height/length z-score or BMI-for-age z-score less than -3
- Hypersensitivity to any of the study drugs (rifampicin, isoniazid, pyrazinamide or ethambutol)
- For Main Trial (Step 2) participants, previously enrolled in the Lead-in PK Study (Step 1)
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Arm 1: 8 week duration
N = 40, 8 weeks of odRHZE
|
odR for main trial determined from Lead-in PK study 75 mg tablet, and 150 or 300 mg capsule, dosed by weight and age
Andre navne:
50 mg tablet, dosed by weight and age
Andre navne:
150 mg tablet, dosed by weight and age
Andre navne:
100 mg tablet, dosed by weight and age
Andre navne:
standard of care and only the 75 mg tablet will be used
Andre navne:
|
|
Eksperimentel: Arm 2: 11 week duration
N = 40, 8 weeks of odRHZE followed by 3 weeks of odRH
|
odR for main trial determined from Lead-in PK study 75 mg tablet, and 150 or 300 mg capsule, dosed by weight and age
Andre navne:
50 mg tablet, dosed by weight and age
Andre navne:
150 mg tablet, dosed by weight and age
Andre navne:
100 mg tablet, dosed by weight and age
Andre navne:
standard of care and only the 75 mg tablet will be used
Andre navne:
|
|
Eksperimentel: Arm 3: 14 week duration
N = 40, 8 weeks of odRHZE followed by 6 weeks of odRH
|
odR for main trial determined from Lead-in PK study 75 mg tablet, and 150 or 300 mg capsule, dosed by weight and age
Andre navne:
50 mg tablet, dosed by weight and age
Andre navne:
150 mg tablet, dosed by weight and age
Andre navne:
100 mg tablet, dosed by weight and age
Andre navne:
standard of care and only the 75 mg tablet will be used
Andre navne:
|
|
Eksperimentel: Arm 4: 17 week duration
N = 40, 8 weeks of odRHZE followed by 9 weeks of odRH
|
odR for main trial determined from Lead-in PK study 75 mg tablet, and 150 or 300 mg capsule, dosed by weight and age
Andre navne:
50 mg tablet, dosed by weight and age
Andre navne:
150 mg tablet, dosed by weight and age
Andre navne:
100 mg tablet, dosed by weight and age
Andre navne:
standard of care and only the 75 mg tablet will be used
Andre navne:
|
|
Aktiv komparator: Arm 5: Control (17 or 24 week duration)
N = 40, 8 week of RHZ(E) followed by 9 weeks (5a - non-severe TB) or 16 weeks (5b - severe TB) of RH
|
odR for main trial determined from Lead-in PK study 75 mg tablet, and 150 or 300 mg capsule, dosed by weight and age
Andre navne:
50 mg tablet, dosed by weight and age
Andre navne:
150 mg tablet, dosed by weight and age
Andre navne:
100 mg tablet, dosed by weight and age
Andre navne:
standard of care and only the 75 mg tablet will be used
Andre navne:
|
|
Eksperimentel: Step 1: PK - Dosing Schedule A > B
N = 15
Dosing schedules are by weight and age, with Schedule A a higher dose of RIF (totaling 250 - 1650mg) than Schedule B (totaling 200 - 1350mg) |
odR for main trial determined from Lead-in PK study 75 mg tablet, and 150 or 300 mg capsule, dosed by weight and age
Andre navne:
50 mg tablet, dosed by weight and age
Andre navne:
150 mg tablet, dosed by weight and age
Andre navne:
100 mg tablet, dosed by weight and age
Andre navne:
standard of care and only the 75 mg tablet will be used
Andre navne:
|
|
Eksperimentel: Step 1: PK - Dosing Schedule B > A
N = 15
Dosing schedules are by weight and age, with Schedule A a higher dose of RIF (totaling 250 - 1650mg) than Schedule B (totaling 200 - 1350mg) |
odR for main trial determined from Lead-in PK study 75 mg tablet, and 150 or 300 mg capsule, dosed by weight and age
Andre navne:
50 mg tablet, dosed by weight and age
Andre navne:
150 mg tablet, dosed by weight and age
Andre navne:
100 mg tablet, dosed by weight and age
Andre navne:
standard of care and only the 75 mg tablet will be used
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Step 2: Unfavorable TB treatment outcome
Tidsramme: 48 weeks
|
A participant has unfavorable treatment outcomes if they fail to meet either of the following criteria:
|
48 weeks
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Step 1: Safety measured by occurrence of Grade 3 to 5 Adverse Events after the first dose of study treatment by period in Lead-in PK study
Tidsramme: data collected from individual participants for 2 regimens of 4 weeks each, up to 8 weeks total
|
Occurrence of at least one new or worsened Grade 3-5 Adverse Event (AE) after the first dose of study treatment by period.
|
data collected from individual participants for 2 regimens of 4 weeks each, up to 8 weeks total
|
|
Step 1: Tolerability Measured by discontinuation of at least one drug in Lead-in PK study
Tidsramme: data collected from individual participants for 2 regimens of 4 weeks each, up to 8 weeks total
|
Permanent discontinuation of at least one drug in the study regimen during each treatment period due to an AE of any grade that is either safety- or tolerability-related, death due to toxicity (probably/possibly/certainly) related to one or more of the study drugs, or participant/parent/guardian request.
|
data collected from individual participants for 2 regimens of 4 weeks each, up to 8 weeks total
|
|
Step 1: Pharmacokinetics of optimized-dose rifampicin: (AUC0-24)
Tidsramme: data collected at week 4 (and week 8) visit lead-in PK study; pre-dose (0 hour), 1, 2, 4, 8 and 24 hour post dose
|
Area under the concentration time curve over 24 hours (AUC0-24)
|
data collected at week 4 (and week 8) visit lead-in PK study; pre-dose (0 hour), 1, 2, 4, 8 and 24 hour post dose
|
|
Step 1: Pharmacokinetics of optimized-dose rifampicin: (Cmax)
Tidsramme: data collected at week 4 (and week 8) visit lead-in PK study; pre-dose (0 hour), 1, 2, 4, 8 and 24 hour post dose
|
Maximum concentration (Cmax)
|
data collected at week 4 (and week 8) visit lead-in PK study; pre-dose (0 hour), 1, 2, 4, 8 and 24 hour post dose
|
|
Step 1: Acceptability of optimized-dose rifampicin summarized by participant count
Tidsramme: baseline (at dose 1), week 4, week 8
|
Participant and/or parent/guardian responses to rifampicin acceptability question of "Overall, how did you/your child feel about taking this medicine?",
scored on a likert scale from 1-5 with higher scores being more acceptable.
Summarized by number of responses per score.
|
baseline (at dose 1), week 4, week 8
|
|
Step 2: Safety Measured by Occurrence of at least one new or worsened Grade 3-5 adverse event after the first dose of study treatment in Main Trial
Tidsramme: up to 28 weeks
|
Occurrence of at least one new or worsened Grade 3-5 adverse event after the first dose of study treatment and during the 28 weeks following randomization, where 28 weeks is 4 weeks beyond the longest scheduled treatment duration of 24 weeks.
|
up to 28 weeks
|
|
Step 2: Tolerability Measured by discontinuation of at least one drug in Main Trial
Tidsramme: up to 24 weeks
|
Permanent discontinuation of at least one drug in the study regimen prior to the end of the assigned treatment period due to an AE of any grade that is either safety- or tolerability-related, death due to toxicity (probably/possibly/certainly) related to one or more of the study drugs, or participant/parent/guardian request.
|
up to 24 weeks
|
|
Step 2: Lung function post-TB treatment
Tidsramme: week 48
|
The outcome of interest is abnormal lung function classified as having at least one of the following physiological findings based on results of spirometry and oscillometry (FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity):
|
week 48
|
|
Step 2: Acceptability of optimized-dose rifampicin summarized by participant count
Tidsramme: baseline (at dose 1), week 4, week 8
|
Participant and/or parent/guardian responses to rifampicin acceptability question of "Overall, how did you/your child feel about taking this medicine?",
scored on a likert scale from 1-5 with higher scores being more acceptable.
Summarized by number of responses per score.
|
baseline (at dose 1), week 4, week 8
|
|
Step 2: Acceptability of overall TB treatment regimen summarized by participant count
Tidsramme: week 4, week 8
|
Participant and/or parent/guardian responses to overall TB treatment regimen acceptability question of "In the last 4 weeks, how did you/your child feel about taking this TB treatment regimen, considering all of the TB medicines in the regimen together?",
scored on a likert scale from 1-5 with higher scores being more acceptable.
Summarized by number of responses per score.
|
week 4, week 8
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Anthony Garcia-Prats, MD, MSc, PhD, UW School of Medicine and Public Health
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Infektioner
- Gram-positive bakterielle infektioner
- Bakterielle infektioner
- Bakterielle infektioner og mykoser
- Actinomycetales infektioner
- Mycobacterium infektioner
- Tuberkulose
- Organiske kemikalier
- Pyridiner
- Heterocykliske forbindelser, 1-ring
- Heterocykliske forbindelser
- Heterocykliske forbindelser, smeltet ring
- Fysiske fænomener
- Polycykliske forbindelser
- Aminer
- Uorganiske kemikalier
- Elementer
- Heterocykliske forbindelser, 4 eller flere ringe
- Ioner
- Elektrolytter
- Rifamycins
- Lactams, makrocyklisk
- Makrocykliske forbindelser
- Pyraziner
- Gasser
- Elementære partikler
- Hydraziner
- Isonicotinsyrer
- Syrer, heterocykliske
- Ethylendiaminer
- Diaminer
- Polyaminer
- Kationer, monovalent
- Kationer
- Brint
- Nukleoner
- Rifampin
- Ethambutol
- Isoniazid
- Pyrazinamid
- Protoner
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 2026-0205
- SMPH | Pediatrics - GPAM (Anden identifikator: UW Madison)
- Protocol Version 2/10/26 (Anden identifikator: UW Madison)
- 1U01AI192041-01 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
- SAP
- ICF
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
produkt fremstillet i og eksporteret fra U.S.A.
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Tuberkulose
-
NCT07157904Ikke rekrutterer endnuTuberkulose | Mycobacterium Tuberculosis | Lungetuberkuloser
-
NCT03044509RekrutteringTuberkulose | Mycobacterium Tuberculosis
-
NCT00414882AfsluttetMycobacterium Tuberculosis
-
NCT00421798AfsluttetMycobacterium Tuberculosis
-
NCT04121494AfsluttetTuberkulose | Mycobacterium Tuberculosis, Beskyttelse mod
-
NCT00814827Aktiv, ikke rekrutterendeOpportunistiske infektioner | Mycobacterium Tuberculosis | Ikke-tuberkuløse mykobakterier
-
NCT00460759AfsluttetMycobacterium Tuberculosis
-
NCT07486024Ikke rekrutterer endnuAntibiotikaresistens | Mycobacterium Tuberculosis | MDR-TB | Tuberkulose Multi Drug Resistant Active
Kliniske forsøg med Rifampicin
-
NCT07253688RekrutteringStaphylococcus Aureus Endocarditis | Prostetisk ventilendokarditis
-
NCT01701622Afsluttet
-
NCT02866214AfsluttetEndotel dysfunktion | Endstage nyresygdom
-
NCT07313215RekrutteringPeriprostetisk ledinfektion
-
NCT07134478Aktiv, ikke rekrutterende
-
NCT00669643Afsluttet
-
NCT05597280Rekruttering
-
NCT01802502Afsluttet
-
NCT00621309AfsluttetUønskede lægemiddelinteraktioner