Patient-reported Experiences and Quality of Life Outcomes in the TB-PRACTECAL Clinical Trial

NCT ID: NCT03942354

Last Updated: 2024-05-29

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

Total Enrollment

137 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-09-01

Study Completion Date

2022-05-10

Brief Summary

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PRACTECAL-PRO is a sub-study of a TB-PRACTECAL clinical trial for multidrug resistant Tuberculosis. It evaluates the effectiveness of TB-PRACTECAL interventions from the patient perspective in terms of their quality of life, shared decision making and satisfaction with services.

Detailed Description

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Tolerability of drugs for TB is a complex and dynamic course for patients with drug resistance and can be affected by many different factors. A deeper understanding of the perspectives and experience of men and women participating in novel TB treatment trials will add to the understanding of the safety and efficacy of treatment.

TB-PRACTECAL is a multicentre, open label, phase 2-3 randomised controlled trial evaluating exclusively oral 6 months regimens containing bedaquiline, pretomanid, linezolid +/- moxifloxacin or clofazimine for the treatment of microbiologically confirmed pulmonary M/XDR-TB. It is registered with the ClinicalTrials.gov with identifier number NCT02589782. The trial aims to recruit 630 adults from two sites in Uzbekistan (Nukus and Tashkent) and one site each from Belarus and South Africa.

The TB-PRACTECAL trial assumes that even if the investigational arms would have non-inferior efficacy and safety compared to the standard of care outcomes, patients would prefer a shorter, exclusively oral regimen with a lower pill count. This study therefore aims to describe patient experiences (i.e. the quality of the treatment experience as opposed to the quantity of treatment or the amount of time spent on it).

The PRACTECAL-PRO sub-study aims to answer the question: "What are the perceptions, expectations and experiences of novel TB treatment for adult patients participating in a six-month regimen clinical trial in Uzbekistan, South Africa and Belarus?"

The objectives for the analysis are:

* To compare baseline scores between trial patients (all interventional arm patients plus standard of care patients) with healthy controls.
* To assess changes in scores over time in patients on the intervention arms and patients on the standard of care arm.
* To assess the utility of the SF 12 and SGRQ in a TB clinical trial.

Conditions

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Multidrug Resistant Tuberculosis

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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Intervention arm

A total of 54 intervention arm trial patients (from TB-PRACTECAL trial) are anticipated across all three sites: South Africa, Belarus, and Karakalpakstan.

54 matched healthy controls are anticipated.

Bedaquiline

Intervention Type DRUG

Bedaquiline is a diarylquinoline class antimicrobial which blocks the proton pump for ATP synthase of mycobacteria. This in turn blocks the ATP production required for cellular energy production and leading to cell death.

Pretomanid

Intervention Type DRUG

Pretomanid is a nitroimidazole class antimicrobial which interferes with cell wall biosynthesis in mycobacteria. It may have other mechanisms of action as well in non-replicating mycobacteria.

Moxifloxacin

Intervention Type DRUG

Moxifloxacin is an 8-methoxyquinolone class antimicrobial that is a potent inhibitor of DNA gyrase and topoisomerase IV in bacteria

Linezolid

Intervention Type DRUG

Linezolid, an oxazolidinone class antimicrobial which works by inhibiting ribosomal protein synthesis. It is approved for Gram-positive bacterial infections, and is increasingly being used for drug resistant TB disease.

Clofazimine

Intervention Type DRUG

Clofazimine is a lipophilic riminophenazine licensed for treatment of leprosy. Its mechanism(s) of action remains unclear, but existing evidence suggests production of reactive oxygen species within Mycobacterium tuberculosis is one mechanism.

Standard therapy

54 standard therapy trial patients (from TB-PRACTECAL trial) will be recruited across all three sites. Patients will complete measures at baseline, 3 months, 6 months and 12 months.

54 matched healthy controls are anticipated.

Directly observed therapy (DOT)

Intervention Type DRUG

Standard therapy

Interventions

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Bedaquiline

Bedaquiline is a diarylquinoline class antimicrobial which blocks the proton pump for ATP synthase of mycobacteria. This in turn blocks the ATP production required for cellular energy production and leading to cell death.

Intervention Type DRUG

Pretomanid

Pretomanid is a nitroimidazole class antimicrobial which interferes with cell wall biosynthesis in mycobacteria. It may have other mechanisms of action as well in non-replicating mycobacteria.

Intervention Type DRUG

Moxifloxacin

Moxifloxacin is an 8-methoxyquinolone class antimicrobial that is a potent inhibitor of DNA gyrase and topoisomerase IV in bacteria

Intervention Type DRUG

Linezolid

Linezolid, an oxazolidinone class antimicrobial which works by inhibiting ribosomal protein synthesis. It is approved for Gram-positive bacterial infections, and is increasingly being used for drug resistant TB disease.

Intervention Type DRUG

Clofazimine

Clofazimine is a lipophilic riminophenazine licensed for treatment of leprosy. Its mechanism(s) of action remains unclear, but existing evidence suggests production of reactive oxygen species within Mycobacterium tuberculosis is one mechanism.

Intervention Type DRUG

Directly observed therapy (DOT)

Standard therapy

Intervention Type DRUG

Other Intervention Names

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Sirturo R207910 TMC207 PA-824 Avelox, BAY 12-8039 Zyvox Lamprene

Eligibility Criteria

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Inclusion Criteria

* Patients recruited into the TB-PRACTECAL trial in the approved sites OR
* Local healthy-controls of a similar profile in terms of age and gender aged ≥18 years AND
* Literate in the study questionnaire languages
* Able to sign the sub-study informed consent form after agreeing to the additional interviews and completion of questionnaires.

Exclusion Criteria

* TB patients excluded from TB-PRACTECAL clinical trial
* Healthy volenteers with co-morbidities
* Healthy volenteers found to have TB
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Sussex

OTHER

Sponsor Role collaborator

London School of Hygiene and Tropical Medicine

OTHER

Sponsor Role collaborator

THINK TB & HIV Investigative Network

NETWORK

Sponsor Role collaborator

Wits Health Consortium (Pty) Ltd

OTHER

Sponsor Role collaborator

Ministry of Public Health, Republic of Belarus

OTHER_GOV

Sponsor Role collaborator

Ministry of Health, Republic of Uzbekistan

OTHER_GOV

Sponsor Role collaborator

Medecins Sans Frontieres, Netherlands

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Beverley Stringer

Role: PRINCIPAL_INVESTIGATOR

MSF

Locations

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Republican Scientific and Practical Centre for Pulmonology and Tuberculosis hospital

Minsk, , Belarus

Site Status

THINK Clinical Trial Unit, Hillcrest

Durban, KwaZulu-Natal, South Africa

Site Status

Doris Goodwin Hospital

Pietermaritzburg, KwaZulu-Natal, South Africa

Site Status

Helen Jospeh Hospital

Johannesburg, , South Africa

Site Status

Republican TB Hospital No. 2

Nukus, Karakalpakstan, Uzbekistan

Site Status

Sh Alimov Republican Specialised Scientific-Practical Medical Centre for Phthysiology and Pulmonology Hospital

Tashkent, , Uzbekistan

Site Status

Countries

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Belarus South Africa Uzbekistan

References

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Stringer B, Lowton K, James N, Nyang'wa BT. Capturing patient-reported and quality of life outcomes with use of shorter regimens for drug-resistant tuberculosis: mixed-methods substudy protocol, TB PRACTECAL-PRO. BMJ Open. 2021 Sep 6;11(9):e043954. doi: 10.1136/bmjopen-2020-043954.

Reference Type DERIVED
PMID: 34489263 (View on PubMed)

Other Identifiers

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PRACTECAL-PRO

Identifier Type: -

Identifier Source: org_study_id

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