The purpose of the study is to evaluate the efficacy (how well the medicines work) and tolerability (whether participants stop treatment because of side effects from a drug or treatment) of an anti-TB treatment regimen that compares two doses of linezolid (LZD), combined with bedaquiline (BDQ), delamanid (DLM), and clofazimine (CFZ). This study will also measure the level of these medicines in the participants' blood.
There is currently no "standard of care" or single standardized treatment regimen recommended for everyone with drug resistant-tuberculosis (DR- TB). Current DR-TB treatments may not be well tolerated and can often have side effects. There is a need to identify drugs with enough anti-TB activity (treatment against TB) and good safety profiles that can improve outcomes in the treatment of DR-TB. The main purpose of this study is to evaluate the efficacy and tolerability of a new shorter course anti-TB treatment regimen that compares two dosing strategies of linezolid (LZD), combined with bedaquiline (BDQ), delamanid (DLM), and clofazimine (CFZ). As a secondary aim, the study will also assess the safety (the level and type of side effects from a drug or treatment) of the combination of these drugs. Everyone in the study will take these drugs once a day for the entire treatment period: BDQ, DLM, and CFZ. The difference between the two treatment groups in the study is in how participants will take the fourth drug: LZD. Participants in group A will take one dose of LZD once a day for the entire treatment period. Participants in group B will take a higher dose of LZD once a day for 4 weeks and then continue taking that higher dose of LZD just three times a week for the rest of the treatment period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
138
One 600mg tablet taken orally once daily (QD) in the morning during weeks 1-26
Two 600mg tablets taken orally once daily (QD) in the morning during weeks 1-4
Two 600mg tablets taken orally three times per week (TIW; Mon-Wed-Fri) in the morning during weeks 5-26
Gaborone CRS (Site ID: 12701)
Gaborone, South-East District, Botswana
Instituto de Pesquisa Clinica Evandro Chagas (IPEC) CRS (Site ID: 12101)
Rio de Janeiro, Brazil
Cumulative probability of sputum culture conversion
Time frame: Up to 26 weeks
Cumulative probability of permanent discontinuation of at least one anti-TB drug due to adverse events, intolerance, or death
Time frame: Up to 26 weeks
Cumulative probability of sputum culture conversion
Probability of sputum culture conversion in liquid media
Time frame: At week 8
Cumulative probability of sputum culture conversion
Time frame: At week 16
Cumulative probability of sputum culture conversion
Time frame: At week 26
Cumulative probability of sputum culture conversion
Time frame: At week 38
Cumulative probability of permanent discontinuation of LZD due to AEs, intolerance, or death; temporary discontinuation of LZD for any reason; and dose reduction of LZD
Time frame: Up to 26 weeks
Cumulative probability of treatment-related adverse events
Time frame: Up to 26 weeks
Cumulative probability of unfavorable TB treatment outcome
Time frame: At week 26
Cumulative probability of unfavorable TB treatment outcome
Time frame: At week 38
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Two 100mg tablets taken orally once daily in the morning during weeks 1-8
One 100mg tablet taken orally once daily in the morning during weeks 9-26
Six 50mg tablets taken orally once daily in the morning during weeks 1-26
Three 100mg capsules taken orally once daily in the morning during weeks 1-2
One 100mg capsule taken orally once daily in the morning during weeks 3-26
GHESKIO Institute of Infectious Diseases and Reproductive Health (GHESKIO - IMIS) CRS (Site ID: 31730)
Port-au-Prince, Haiti
Les Centres GHESKIO Clinical Research Site (GHESKIO-INLR) CRS (Site ID: 30022)
Port-au-Prince, Haiti
Barranco CRS (Site ID: 11301)
Lima, Peru
De La Salle Health Science Institute Angelo King Medical Research Center (DLSHSI-AKMRC) (Site ID: 31981)
Cavite, Philippines
Wits Helen Joseph Hospital CRS (Wits HJH CRS) (Site ID: 11101)
Johannesburg, Gauteng, South Africa
Durban International CRS (Site ID: 11201)
Durban, KwaZulu-Natal, South Africa
Rustenburg CRS (Site ID: 31684)
Rustenburg, North West, South Africa
University of Cape Town Lung Institute (UCTLI) CRS (Site ID: 31792)
Cape Town, Western Cape, South Africa
...and 3 more locations
Cumulative probability of unfavorable TB treatment outcome
Time frame: At week 72
Delamanid minimum plasma concentration (Cmin)
Time frame: At week 4
Delamanid maximum plasma concentration (Cmax)
Time frame: At week 4
Delamanid time to reach maximum plasma concentration (Tmax)
Time frame: At week 4
Delamanid area under the concentration-time curve (AUC)
Time frame: At week 4
Delamanid apparent oral clearance (CL/F)
Time frame: At week 4
Linezolid minimum plasma concentration (Cmin)
Time frame: At week 4
Linezolid maximum plasma concentration (Cmax)
Time frame: At week 4
Linezolid time to reach maximum plasma concentration (Tmax)
Time frame: At week 4
Linezolid area under the concentration-time curve (AUC)
Time frame: At week 4
Linezolid apparent oral clearance (CL/F)
Time frame: At week 4
Proportion of doses taken during the treatment period
Time frame: Up to 26 weeks