Sequencing Mycobacteria and Algorithm-determined Resistant Tuberculosis Treatment Trial

NCT ID: NCT05017324

Last Updated: 2021-10-15

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

248 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-21

Study Completion Date

2025-01-31

Brief Summary

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The primary aim of this pragmatic trial is to determine the effectiveness of a Whole Genome Sequencing (WGS) Drug Sensitivity Testing (DST) strategy to guide individualised treatment of rifampicin resistant tuberculosis (RR-TB) patients.

The primary objective is to determine the effectiveness of this WGS DST strategy in patients diagnosed with RR-TB. We will additionally perform an exploratory health economics evaluation of both arms, and will determine the feasibility of the WGS DST strategy.

Detailed Description

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The trial will be a single blinded randomised controlled, pragmatic, medical device trial evaluating a Whole Genome Sequencing (WGS) Drug Sensitivity Testing (DST) strategy to guide individualised treatment of rifampicin resistant tuberculosis (RR-TB) patients. A total of 248 patients diagnosed with RR-TB in the South African Free State province will by randomised to one of two trial arms. 124 patients will be assigned to the intervention arm, consisting of a WGS DST strategy for diagnosing drug resistance profile and an algorithm-determined individualised RR-TB treatment recommendation. 124 patients will be assigned to the control arm where the diagnosis of Mtb drug resistance and individualisation of RR-TB treatment will happen according to the Standard of Care (SOC) procedures.

Conditions

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Rifampicin Resistant Tuberculosis Drug-resistant Tuberculosis Multidrug Resistant Tuberculosis Pulmonary Tuberculoses

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized Controled Phase 4 pragmatic single blinded medical device trial.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants

Study Groups

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WGS DST strategy

WGS DST strategy for diagnosing the TB drug resistance profile and an individualised RR-TB treatment recommendation

Group Type EXPERIMENTAL

WGS DST strategy

Intervention Type DEVICE

WGS DST strategy for diagnosing the TB drug resistance profile and an algorithm-determined individualised RR-TB treatment recommendation

Standard of Care

Standard of care diagnosis of the drug resistance profile and individualised treatment

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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WGS DST strategy

WGS DST strategy for diagnosing the TB drug resistance profile and an algorithm-determined individualised RR-TB treatment recommendation

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Diagnosed with RR-TB
* Diagnosed with pulmonary TB (PTB) or PTB plus extra-pulmonary TB (EPTB)
* ≥18 years of age
* Able to sign informed consent
* Not on TB treatment at time of enrolment

Exclusion Criteria

* Patients diagnosed EPTB without pulmonary involvement
* Patients with TB Meningitis or TB of the bone.
* Has any condition that, in the opinion of the investigator or physician, would preclude provision of informed consent, make participation in the study unsafe, complicate interpretation of study outcome data, interfere with achieving the study objectives or compromise patient safety.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aurum Institute

OTHER

Sponsor Role collaborator

University of Stellenbosch

OTHER

Sponsor Role collaborator

University of the Free State

UNKNOWN

Sponsor Role collaborator

Free State Department of Health

UNKNOWN

Sponsor Role collaborator

Universiteit Antwerpen

OTHER

Sponsor Role lead

Responsible Party

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Annelies Van Rie

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gavin Churchyard, PhD, MD

Role: PRINCIPAL_INVESTIGATOR

Aurum Institute

Annelies Van Rie, PhD, MD

Role: PRINCIPAL_INVESTIGATOR

Universiteit Antwerpen

Rob M Warren, PhD

Role: PRINCIPAL_INVESTIGATOR

Stellenbosch University, MRC

Salome Charalambous, PhD

Role: PRINCIPAL_INVESTIGATOR

Aurum Institute

Locations

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Free State Department of Health Clinics

Bloemfontein, Free State, South Africa

Site Status RECRUITING

Countries

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South Africa

Central Contacts

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Elise De Vos, MSc

Role: CONTACT

0032477715350

Annelies Van Rie, PhD, MD

Role: CONTACT

Facility Contacts

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Salome Charalambous, PhD

Role: primary

+27 10 590 1389

References

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Van Rie A, De Vos E, Costa E, Verboven L, Ndebele F, Heupink TH, Abrams S; SMARTT team; Fanampe B, Van der Spoel Van Dyk A, Charalambous S, Churchyard G, Warren R. Sequencing Mycobacteria and Algorithm-determined Resistant Tuberculosis Treatment (SMARTT): a study protocol for a phase IV pragmatic randomized controlled patient management strategy trial. Trials. 2022 Oct 8;23(1):864. doi: 10.1186/s13063-022-06793-w.

Reference Type DERIVED
PMID: 36209235 (View on PubMed)

Other Identifiers

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T001018N

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2020-004084-10

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

AUR1-11-248

Identifier Type: -

Identifier Source: org_study_id