- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT01782950
Evaluation of the Pharmacokinetics of Antituberculosis Drugs and Tuberculosis Treatment Outcomes (SOUTH)
Evaluation of the Pharmacokinetics of Antituberculosis Drugs and Tuberculosis Treatment Outcomes in HIV-tuberculosis Co-infected Ugandan Adults
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
During the study periodic monitoring will be conducted to ensure that the protocol and Good Clinical Practices (GCPs) are being followed.The monitors may review source documents to confirm that the data recorded on CRFs is accurate. The study site may be subject to review by the Institutional Review Board (IRB) and/or appropriate regulatory authorities.
A CRF will be completed for each included subject and will be signed by the investigator or by an authorized staff member to attest that the data is true. Any corrections to entries made in the CRFs, source documents must be dated, initialed and explained (if necessary) and should not obscure the original entry. Qualit assurance will as also be performed regularly on the CRFs.
The primary end point will be analyzed using Time to event (cure, death, relapse etc)analysis and failure rates and hazard ratios will be calculated accordig to categorical drug concentrations with proposed cutt offs.
Secondary end points will be analysed using time to event for occurence of toxicities which will also be corelated to the drug concentrations.
Studietype
Registrering (Forventet)
Fase
- Fase 4
Kontakter og plasseringer
Studiekontakt
- Navn: Andrew Kambugu, MMED
- Telefonnummer: 227 +256-414-307000
- E-post: akambugu@idi.co.ug
Studiesteder
-
-
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Kampala, Uganda, 256
- Rekruttering
- Infectious Diseases Institute
-
Ta kontakt med:
- Christine Sekaggya, MMed
- Telefonnummer: 370 +256312307000
- E-post: csekaggya@idi.co.ug
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Hovedetterforsker:
- Barbara Castelnuovo, MBChB, PhD
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Evidence of a personally signed and dated informed consent
- Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
- Age of ≥18 years
- First episode of pulmonary TB i.e. proven or highly suspected TB considered for TB treatment qualifying for 6 months anti-Tb drugs regimen
- Confirmed HIV-1 infection
Exclusion Criteria:
- Unable to provide informed consent
- Documented or highly suspected TB infection of any organs/systems other than the lung requiring TB treatment longer than 6 months
- Previously treated for a mycobacterial infection (TB or atypical mycobacterial infection, active or latent)
- Pregnancy or planned pregnancy within the next year
- Unwillingness to perform pregnancy test
- Decompensated liver disease and/or aminotransferases >5x ULN
- GFR < 50 ml/min
- Co-morbidities reducing life expectancy to <1 year (e.g. cancer)
- Patient wishes to take part in another interventional study
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Annen: anti-tuberculosis drugs
Rifampicin, Isoniazid, Ethambutol, Pyrazinamide tablets 3 to 5 tablets once daily for 2 months followed by Rifampicin, Isoniazid 3 to 5 tablets once daily for 4 months
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Rifampicin, Isoniazid, Ethambutol, Pyrazinamide: 3, 4 or 5 tablets daily for weight below 55kg, above 55kg or above 70kg respectively for first 2 months followed by Rifampicin, Isoniazid: 3, 4 or 5 tablets daily for patients' weight below 55kg, above 55kg or above 70kg respectively for 4 months
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
clinical outcome
Tidsramme: At the end of treatment (6 months after enrolmet)
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To investigate the association between serum concentrations of antituberculosis drugs and tuberculosis treatment response in HIV-TB-co-infected individuals.
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At the end of treatment (6 months after enrolmet)
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Cmax
Tidsramme: At 2 weeks, 8 weeks and 24 weeks after anti-tuberculosis drug initiation
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To investigate the steady-state pharmacokinetic parameters of anti-TB drugs at different time-points over the course of TB-treatment
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At 2 weeks, 8 weeks and 24 weeks after anti-tuberculosis drug initiation
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Number of adverse events
Tidsramme: 2 weeks, 8 weeks and 24 weeks after anti-tuberculosis drug initiation
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To assess the safety and tolerability of anti-TB drugs based on the WHO guidelines
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2 weeks, 8 weeks and 24 weeks after anti-tuberculosis drug initiation
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ART trough levels
Tidsramme: At 2 weeks, 8 weeks and 24 weeks after anti-tuberculosis drug initiation
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To correlate the effect of anti-TB drugs on plasma concentrations of efavirenz or protease inhibitors and vice versa.
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At 2 weeks, 8 weeks and 24 weeks after anti-tuberculosis drug initiation
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Isoniazid Cmax
Tidsramme: At 2 weeks, 8 weeks and 24 weeks
|
To evaluate the effect of acetylator geno-and phenotype (NAT-2 gene) on isoniazid plasma concentrations and toxicity
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At 2 weeks, 8 weeks and 24 weeks
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: Barbara Castelnuovo, MD, PhD, Infectious Diseases Institute
Publikasjoner og nyttige lenker
Generelle publikasjoner
- Gurumurthy P, Ramachandran G, Hemanth Kumar AK, Rajasekaran S, Padmapriyadarsini C, Swaminathan S, Bhagavathy S, Venkatesan P, Sekar L, Mahilmaran A, Ravichandran N, Paramesh P. Decreased bioavailability of rifampin and other antituberculosis drugs in patients with advanced human immunodeficiency virus disease. Antimicrob Agents Chemother. 2004 Nov;48(11):4473-5. doi: 10.1128/AAC.48.11.4473-4475.2004.
- Chideya S, Winston CA, Peloquin CA, Bradford WZ, Hopewell PC, Wells CD, Reingold AL, Kenyon TA, Moeti TL, Tappero JW. Isoniazid, rifampin, ethambutol, and pyrazinamide pharmacokinetics and treatment outcomes among a predominantly HIV-infected cohort of adults with tuberculosis from Botswana. Clin Infect Dis. 2009 Jun 15;48(12):1685-94. doi: 10.1086/599040.
- Weiner M, Benator D, Burman W, Peloquin CA, Khan A, Vernon A, Jones B, Silva-Trigo C, Zhao Z, Hodge T; Tuberculosis Trials Consortium. Association between acquired rifamycin resistance and the pharmacokinetics of rifabutin and isoniazid among patients with HIV and tuberculosis. Clin Infect Dis. 2005 May 15;40(10):1481-91. doi: 10.1086/429321. Epub 2005 Apr 14.
- Narita M, Hisada M, Thimmappa B, Stambaugh J, Ibrahim E, Hollender E, Ashkin D. Tuberculosis recurrence: multivariate analysis of serum levels of tuberculosis drugs, human immunodeficiency virus status, and other risk factors. Clin Infect Dis. 2001 Feb 1;32(3):515-7. doi: 10.1086/318490. Epub 2001 Jan 25.
- Gumbo T, Louie A, Deziel MR, Liu W, Parsons LM, Salfinger M, Drusano GL. Concentration-dependent Mycobacterium tuberculosis killing and prevention of resistance by rifampin. Antimicrob Agents Chemother. 2007 Nov;51(11):3781-8. doi: 10.1128/AAC.01533-06. Epub 2007 Aug 27.
- Sekaggya-Wiltshire C, Chirehwa M, Musaazi J, von Braun A, Buzibye A, Muller D, Gutteck U, Motta I, Calcagno A, Fehr JS, Kambugu A, Castelnuovo B, Lamorde M, Denti P. Low Antituberculosis Drug Concentrations in HIV-Tuberculosis-Coinfected Adults with Low Body Weight: Is It Time To Update Dosing Guidelines? Antimicrob Agents Chemother. 2019 May 24;63(6):e02174-18. doi: 10.1128/AAC.02174-18. Print 2019 Jun. Erratum In: Antimicrob Agents Chemother. 2020 Mar 24;64(4):
- Sekaggya-Wiltshire C, von Braun A, Lamorde M, Ledergerber B, Buzibye A, Henning L, Musaazi J, Gutteck U, Denti P, de Kock M, Jetter A, Byakika-Kibwika P, Eberhard N, Matovu J, Joloba M, Muller D, Manabe YC, Kamya MR, Corti N, Kambugu A, Castelnuovo B, Fehr JS. Delayed Sputum Culture Conversion in Tuberculosis-Human Immunodeficiency Virus-Coinfected Patients With Low Isoniazid and Rifampicin Concentrations. Clin Infect Dis. 2018 Aug 16;67(5):708-716. doi: 10.1093/cid/ciy179.
- Kwizera R, Parkes-Ratanshi R, Page ID, Sekaggya-Wiltshire C, Musaazi J, Fehr J, Castelnuovo B, Kambugu A, Denning DW. Elevated Aspergillus-specific antibody levels among HIV infected Ugandans with pulmonary tuberculosis. BMC Pulm Med. 2017 Nov 21;17(1):149. doi: 10.1186/s12890-017-0500-9.
- Sekaggya-Wiltshire C, Castelnuovo B, von Braun A, Musaazi J, Muller D, Buzibye A, Gutteck U, Henning L, Ledergerber B, Corti N, Lamorde M, Fehr J, Kambugu A. Cohort profile of a study on outcomes related to tuberculosis and antiretroviral drug concentrations in Uganda: design, methods and patient characteristics of the SOUTH study. BMJ Open. 2017 Sep 18;7(9):e014679. doi: 10.1136/bmjopen-2016-014679.
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Forventet)
Studiet fullført (Forventet)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Infeksjoner
- Bakterielle infeksjoner
- Bakterielle infeksjoner og mykoser
- Gram-positive bakterielle infeksjoner
- Actinomycetales infeksjoner
- Mycobacterium infeksjoner
- Tuberkulose
- Molekylære mekanismer for farmakologisk virkning
- Anti-infeksjonsmidler
- Nukleinsyresyntesehemmere
- Enzymhemmere
- Antimetabolitter
- Hypolipidemiske midler
- Lipidregulerende midler
- Antibakterielle midler
- Leprostatiske midler
- Cytokrom P-450 enzymindusere
- Cytokrom P-450 CYP3A indusere
- Antituberkulære midler
- Antibiotika, Antituberkulær
- Cytokrom P-450 CYP2B6 indusere
- Cytokrom P-450 CYP2C8 indusere
- Cytokrom P-450 CYP2C19 indusere
- Cytokrom P-450 CYP2C9 indusere
- Fettsyresyntesehemmere
- Rifampin
- Isoniazid
- Pyrazinamid
- Ethambutol
Andre studie-ID-numre
- IDI
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