Pulmonary Tuberculosis Patients With Diabetes Mellitus

NCT ID: NCT02106039

Last Updated: 2019-04-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

350 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-28

Study Completion Date

2017-12-21

Brief Summary

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The purpose of this study is to evaluate the effect of enhanced glycemic monitoring of diabetes upon diabetes glycaemic control during tuberculosis treatment in tuberculosis- diabetes patients.

Detailed Description

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Tight glycemic control may improve tuberculosis (TB) treatment outcome and help reduce symptoms. However, active TB and TB treatment hamper glycemic control. Patients starting TB treatment experience rapid changes in appetite, body composition, and inflammation (which increases insulin resistance); inflammation is a feature of untreated TB and following an increase as a result of initial bacterial killing, inflammation subsides with successful treatment. In addition, TB medication (rifampicin) increases the metabolism of oral anti-diabetic drugs including the widely used sulphonylureas and thiazolidinediones, though a possible interaction with the antidiabetic drug metformin has not been previously examined. Frequent monitoring of blood glucose with adjustments in anti-diabetes medication during the course of TB treatment may therefore be needed. However, frequent monitoring is associated with additional costs, and tools and skills for glucose monitoring and diabetes treatment may be lacking in TB or pulmonary clinics, creating a need to refer patients to other health providers. As such, a less intense schedule, preferably following the established decision points in TB treatment after 2 and 6 months would offer significant advantage. None of these issues have been addressed systematically so far.

Conditions

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Diabetes Mellitus Pulmonary Tuberculosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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intensive monitoring

more intensive monitoring strategy of blood glucose and clinical review

Group Type EXPERIMENTAL

intensive monitoring

Intervention Type PROCEDURE

standard monitoring

glucose monitoring followed the prevailing practice at each site

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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intensive monitoring

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* adult (\> 18 years old) diabetes mellitus patients
* diagnosed as having active pulmonary TB
* willing to join the study

Exclusion Criteria

* under TB treatment more than 72 hours
* steroid-induced or gestational diabetes
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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London School of Hygiene and Tropical Medicine

OTHER

Sponsor Role collaborator

Radboud University Medical Center

OTHER

Sponsor Role collaborator

Leiden University Medical Center

OTHER

Sponsor Role collaborator

University of Stellenbosch

OTHER

Sponsor Role collaborator

St George's, University of London

OTHER

Sponsor Role collaborator

University of Otago

OTHER

Sponsor Role collaborator

University of Medicine and Pharmacy Craiova

OTHER

Sponsor Role collaborator

University Medical Center Groningen

OTHER

Sponsor Role collaborator

Universidad Peruana Cayetano Heredia

OTHER

Sponsor Role collaborator

Universitas Padjadjaran

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hazel Dockrell, Prof

Role: PRINCIPAL_INVESTIGATOR

London School of Hygiene and Tropical Medicine

Reinout van Crevel, MD, PhD

Role: STUDY_DIRECTOR

Radboud Universisty Nijmegen Medical Center

Locations

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Faculty of Medicine, Universitas Padjadjaran

Bandung, West Java, Indonesia

Site Status

Universidad Peruana Cayetano Heredia

Lima, San Martin de Porres, Peru

Site Status

University of Medicine and Pharmacy Craiova

Bucharest, , Romania

Site Status

Countries

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Indonesia Peru Romania

References

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Baker MA, Harries AD, Jeon CY, Hart JE, Kapur A, Lonnroth K, Ottmani SE, Goonesekera SD, Murray MB. The impact of diabetes on tuberculosis treatment outcomes: a systematic review. BMC Med. 2011 Jul 1;9:81. doi: 10.1186/1741-7015-9-81.

Reference Type BACKGROUND
PMID: 21722362 (View on PubMed)

Ruslami R, Aarnoutse RE, Alisjahbana B, van der Ven AJ, van Crevel R. Implications of the global increase of diabetes for tuberculosis control and patient care. Trop Med Int Health. 2010 Nov;15(11):1289-99. doi: 10.1111/j.1365-3156.2010.02625.x.

Reference Type BACKGROUND
PMID: 20955495 (View on PubMed)

Bidstrup TB, Stilling N, Damkier P, Scharling B, Thomsen MS, Brosen K. Rifampicin seems to act as both an inducer and an inhibitor of the metabolism of repaglinide. Eur J Clin Pharmacol. 2004 Apr;60(2):109-14. doi: 10.1007/s00228-004-0746-z. Epub 2004 Mar 19.

Reference Type BACKGROUND
PMID: 15034704 (View on PubMed)

Hatorp V, Hansen KT, Thomsen MS. Influence of drugs interacting with CYP3A4 on the pharmacokinetics, pharmacodynamics, and safety of the prandial glucose regulator repaglinide. J Clin Pharmacol. 2003 Jun;43(6):649-60.

Reference Type BACKGROUND
PMID: 12817528 (View on PubMed)

Jaakkola T, Backman JT, Neuvonen M, Laitila J, Neuvonen PJ. Effect of rifampicin on the pharmacokinetics of pioglitazone. Br J Clin Pharmacol. 2006 Jan;61(1):70-8. doi: 10.1111/j.1365-2125.2005.02515.x.

Reference Type BACKGROUND
PMID: 16390353 (View on PubMed)

Niemi M, Backman JT, Neuvonen M, Neuvonen PJ. Effect of rifampicin on the pharmacokinetics and pharmacodynamics of nateglinide in healthy subjects. Br J Clin Pharmacol. 2003 Oct;56(4):427-32. doi: 10.1046/j.1365-2125.2003.01884.x.

Reference Type BACKGROUND
PMID: 12968988 (View on PubMed)

Niemi M, Backman JT, Neuvonen M, Neuvonen PJ, Kivisto KT. Rifampin decreases the plasma concentrations and effects of repaglinide. Clin Pharmacol Ther. 2000 Nov;68(5):495-500. doi: 10.1067/mcp.2000.111183.

Reference Type BACKGROUND
PMID: 11103752 (View on PubMed)

Niemi M, Backman JT, Neuvonen M, Neuvonen PJ, Kivisto KT. Effects of rifampin on the pharmacokinetics and pharmacodynamics of glyburide and glipizide. Clin Pharmacol Ther. 2001 Jun;69(6):400-6. doi: 10.1067/mcp.2001.115822.

Reference Type BACKGROUND
PMID: 11406737 (View on PubMed)

Niemi M, Kivisto KT, Backman JT, Neuvonen PJ. Effect of rifampicin on the pharmacokinetics and pharmacodynamics of glimepiride. Br J Clin Pharmacol. 2000 Dec;50(6):591-5. doi: 10.1046/j.1365-2125.2000.00295.x.

Reference Type BACKGROUND
PMID: 11136298 (View on PubMed)

Park JY, Kim KA, Kang MH, Kim SL, Shin JG. Effect of rifampin on the pharmacokinetics of rosiglitazone in healthy subjects. Clin Pharmacol Ther. 2004 Mar;75(3):157-62. doi: 10.1016/j.clpt.2003.10.003.

Reference Type BACKGROUND
PMID: 15001966 (View on PubMed)

Park JY, Kim KA, Park PW, Park CW, Shin JG. Effect of rifampin on the pharmacokinetics and pharmacodynamics of gliclazide. Clin Pharmacol Ther. 2003 Oct;74(4):334-40. doi: 10.1016/S0009-9236(03)00221-2.

Reference Type BACKGROUND
PMID: 14534520 (View on PubMed)

Syvalahti E, Pihlajamaki K, Iisalo E. Effect of tuberculostatic agents on the response of serum growth hormone and immunoreactive insulin to intravenous tolbutamide, and on the half-life of tolbutamide. Int J Clin Pharmacol Biopharm. 1976 Mar;13(2):83-9.

Reference Type BACKGROUND
PMID: 1254383 (View on PubMed)

Zilly W, Breimer DD, Richter E. Induction of drug metabolism in man after rifampicin treatment measured by increased hexobarbital and tolbutamide clearance. Eur J Clin Pharmacol. 1975 Dec 19;9(2-3):219-27. doi: 10.1007/BF00614021.

Reference Type BACKGROUND
PMID: 1233266 (View on PubMed)

Related Links

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http://tandem-fp7.eu

official website of TANDEM project

Other Identifiers

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TB-201403.01

Identifier Type: -

Identifier Source: org_study_id

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