Assess the mycobactericidal activity of PA-824 (given at 200 mg daily) when added to first-line tuberculosis (TB) treatment (isoniazid, pyrazinamide, and a rifamycin antibiotic) over 12 weeks of treatment. Funding Source - FDA Office of Orphan Products Development (OOPD)
Phase IIB, 12-week, open-label, single-site, randomized clinical trial with three treatment groups. Patients with drug-sensitive TB will all receive once daily isoniazid and pyrazinamide for 8 weeks followed by 4 weeks of daily isoniazid. In addition, Arm 1 participants will receive PA-824 200 mg daily and rifampin 600 mg daily for 12 weeks. Arm 2 participants will receive PA-824 200 mg daily and rifabutin 300 mg daily for 12 weeks. Arm 3 participants (control group) will receive rifampin for 12 weeks and ethambutol for 8 weeks. Patients will be screened within 1 week of TB diagnosis, will receive 12 weeks of study treatment and will return for follow-up visits at 4, 12, and 36 weeks after study treatment completion. All patients will be referred to the local TB treatment program after completion of study treatment to finish their 24-week TB treatment course.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
157
University of Cape Town Lung Institute
Cape Town, South Africa
Time to Sputum Culture Conversion on Liquid Medium
The time (days) it takes for the sputum to convert from positive to negative.
Time frame: 12 weeks
Number of Participants With Grade 3 or Higher Adverse Events
Any Grade 3 event according to the Division of AIDS (DAIDS) toxicity table
Time frame: 12 weeks
Number of Participants With Permanent Discontinuation of Assigned Study Regimen
If it is in the best interest of a participant to stop the study regimen for any reason
Time frame: 12 weeks
Time to Culture Conversion on Solid Medium
The time (days) it takes for the sputum to convert form positive to negative on solid medium
Time frame: 12 weeks
Percentage of Participants With Sputum Culture Conversion by 8 Weeks of Treatment
Percentage of participants whose sputum converts from positive to negative at Week 8 time point, on solid and liquid media.
Time frame: 8 weeks
Steady State Pharmacokinetics (PK) (AUC) of PA-824 When Given With Rifampin or Rifabutin
AUC of PA-824 when given with either rifampicin or rifabutin to determine steady state Pharmacokinetics (PK) of PA-824.
Time frame: pre-dose and 1, 2, 5, 8, and 24 hours post-dose on Day 14
PK (Cmax) of PA-824 at 200 mg Once Daily With Rifampin or Rifabutin-containing Treatment
The Pharmacokinetic results (Cmax) of the study drug when given with a rifampin or a rifabutin.
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25mg/kg QD
15mg/kg QD
300 mg QD
Time frame: pre-dose and 1, 2, 5, 8, and 24 hours post-dose on Day 14
Relationship Between PA-824 Exposure (AUC) and Rate of Change in Time to Positivity (TTP) Over 12 Weeks
Relationship between PA-824 exposure (AUC) and rate of change in TTP over 12 weeks, using non-linear mixed effects modeling. The data is reported as percentage increase in TTP per 10 unit increase in PA-824 AUC (% increase/10 unit increase PA-824 AUC).
Time frame: 12 weeks