The Safety and Efficacy of BDL(Bedaquiline Plus Delamanid Plus Linezolid) Regimen in Subjects With Pulmonary Infection of Multi-drug Resistant Tuberculosis (MDR-TB) or Rifampicin-Resistant Tuberculosis (RR-TB)
NCT ID: NCT06476210
Last Updated: 2024-06-26
Study Results
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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RECRUITING
PHASE4
45 participants
INTERVENTIONAL
2024-06-30
2026-06-30
Brief Summary
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The main questions it aims to answer are:
1. What is the percentage of participants with favorable treatment outcome at the end of treatment?
2. What are the frequency and degree of AE and SAE associated with BDL regimen?
Participants will take Bedaquiline +Delamanid+ Linezolid for 6 months, option for 9 months for subjects who remain culture positive at month 4 to 6. Safety and efficacy data will be monitored and collected during treatment. A 12 month follow-up will be conducted after treatment completion.
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Detailed Description
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Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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BDL interventionv group
BDL regimen
Drug:bedaquiline 100mg tablets
Other Names:
Bdq TMC-207 bedaquiline 400 mg once daily for 2 weeks then 200mg 3 times per week
Drug:delamanid 50mg tablets
Other Names:
Dlm OPC-67683 delamanid 100mg 2 times daily
Drug:linezolid Scored 600mg tablets
Other Names:
Lzd linezolid 600mg once daily
Interventions
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BDL regimen
Drug:bedaquiline 100mg tablets
Other Names:
Bdq TMC-207 bedaquiline 400 mg once daily for 2 weeks then 200mg 3 times per week
Drug:delamanid 50mg tablets
Other Names:
Dlm OPC-67683 delamanid 100mg 2 times daily
Drug:linezolid Scored 600mg tablets
Other Names:
Lzd linezolid 600mg once daily
Eligibility Criteria
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Inclusion Criteria
* 2.Age 18 years above
* 3.No prior use of neither bedaquiline, delamanid, linezolid, or use for less than 4 weeks
* 4.Positive culture result for mycobacterial at baseline(regardless smear positive or negative). No anti-tuberculosis treatment received within one month.
* 5.For patients who don't have baseline sputum culture results,positive sputum smear and no effective anti-tuberculosis treatment administered
* 6\. No history of respiratory failure or heart failure, and no clinically significant manifestations of arrhythmia, with a QTcF under 450ms
* 7.Promise to adhere to the treatment and follow-up schedule, complete treatment monitoring, and promptly report adverse reactions to the responsible physician
* 8.Voluntarily participate in this study and sign the informed consent form
Exclusion Criteria
* 2.Elevation of ALT or AST ≥3 times the upper limit of normal, or elevation of total bilirubin and direct bilirubin ≥2 times the upper limit of normal
* 3.Pregnant women or those who intent to pregnant during treatment
* 4.Participants who have participated in other drug trials in the past three months
* 5.Known congenital QT interval prolongation or any disease prolonging the QT interval, or QTc\>450 ms
* 6.History of symptomatic arrhythmias or clinically relevant bradycardia
* 7.Any cardiac disease that could precipitate arrhythmias, such as severe hypertension, left ventricular hypertrophy (including hypertrophic cardiomyopathy), or congestive heart failure with decreased left ventricular ejection fraction
* 8.History of known, untreated, persistent hypothyroidism
* 9.Electrolyte disturbances, especially hypokalemia, hypocalcemia, or hypomagnesemia
* 10.History of allergy or known allergic reactions to any investigational drug or related substances
* 11.BMI\<17 kg/m2
* 12.Karnofsky performance score under 50, or as determined by the principal investigator, the anticipated survival of the participant is not expected to exceed 6 months
* 13.Participants expected to require surgical intervention following assessment of their pulmonary disease
Withdrawal Criteria
1. Serious adverse events caused by the intervention
2. Confirmed QTcF interval ≥ 500ms or clinically significant ventricular arrhythmias
3. The expert panel deems the continuation of this combination regimen inappropriate
4. The patient requests withdrawal
18 Years
ALL
No
Sponsors
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Public Health Clinical Medical Center of Chengdu
UNKNOWN
Wuhan Institute for Tuberculosis Control
OTHER
Changsha Central Hospital
OTHER
Anhui Chest Hospital
OTHER
Hunan Chest Hospital
UNKNOWN
Shandong Public Health Clinical Center
OTHER_GOV
Beijing Chest Hospital
OTHER
Responsible Party
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Principal Investigators
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Yuhong Liu, Ph.D
Role: PRINCIPAL_INVESTIGATOR
Beijing Chest Hostal
Mengqiu Gao, Ph.D
Role: PRINCIPAL_INVESTIGATOR
Beijing Chest Hospital
Locations
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Anhui Chest Hospital
Hefei, Anhui, China
Beijing Chest Hospital
Beijing, Beijing Municipality, China
Wuhan Institute for Tuberculosis Control
Wuhan, Hubei, China
Changsha Central Hospital
Changsha, Hunan, China
Hunan Chest Hospital
Changsha, Hunan, China
Shandong Public Health Clinical Center
Jinan, Shandong, China
Public Health Clinical Meadical Center of Chengdu
Chengdu, Sichuan, China
Countries
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Central Contacts
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Facility Contacts
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Juan Du
Role: primary
References
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Dooley KE, Rosenkranz SL, Conradie F, Moran L, Hafner R, von Groote-Bidlingmaier F, Lama JR, Shenje J, De Los Rios J, Comins K, Morganroth J, Diacon AH, Cramer YS, Donahue K, Maartens G; AIDS Clinical Trials Group (ACTG) A5343 DELIBERATE Study Team. QT effects of bedaquiline, delamanid, or both in patients with rifampicin-resistant tuberculosis: a phase 2, open-label, randomised, controlled trial. Lancet Infect Dis. 2021 Jul;21(7):975-983. doi: 10.1016/S1473-3099(20)30770-2. Epub 2021 Feb 12.
Lachatre M, Rioux C, Le Du D, Frechet-Jachym M, Veziris N, Bouvet E, Yazdanpanah Y. Bedaquiline plus delamanid for XDR tuberculosis. Lancet Infect Dis. 2016 Mar;16(3):294. doi: 10.1016/S1473-3099(16)00047-5. No abstract available.
Kim CT, Kim TO, Shin HJ, Ko YC, Hun Choe Y, Kim HR, Kwon YS. Bedaquiline and delamanid for the treatment of multidrug-resistant tuberculosis: a multicentre cohort study in Korea. Eur Respir J. 2018 Mar 22;51(3):1702467. doi: 10.1183/13993003.02467-2017. Print 2018 Mar.
Gao JT, Du J, Wu GH, Pei Y, Gao MQ, Martinez L, Fan L, Chen W, Xie L, Chen Y, Wang H, Jin L, Li GB, Zong PL, Xiong Y, Wu QH, Li MW, Yan XF, Miao YF, Cai QS, Li XJ, Bai DP, Geng SJ, Yang GL, Tang PJ, Zeng Y, Chen XH, Li TX, Cai C, Zhou Y, Zhuo M, Wang JY, Guan WL, Xu L, Shi JC, Shu W, Cheng LL, Teng F, Ning YJ, Xie SH, Sun YX, Zhang LJ, Liu YH. Bedaquiline-containing regimens in patients with pulmonary multidrug-resistant tuberculosis in China: focus on the safety. Infect Dis Poverty. 2021 Mar 19;10(1):32. doi: 10.1186/s40249-021-00819-2.
Blair HA, Scott LJ. Delamanid: a review of its use in patients with multidrug-resistant tuberculosis. Drugs. 2015 Jan;75(1):91-100. doi: 10.1007/s40265-014-0331-4.
Pieterman ED, Keutzer L, van der Meijden A, van den Berg S, Wang H, Zimmerman MD, Simonsson USH, Bax HI, de Steenwinkel JEM. Superior Efficacy of a Bedaquiline, Delamanid, and Linezolid Combination Regimen in a Mouse Tuberculosis Model. J Infect Dis. 2021 Sep 17;224(6):1039-1047. doi: 10.1093/infdis/jiab043.
Tasneen R, Williams K, Amoabeng O, Minkowski A, Mdluli KE, Upton AM, Nuermberger EL. Contribution of the nitroimidazoles PA-824 and TBA-354 to the activity of novel regimens in murine models of tuberculosis. Antimicrob Agents Chemother. 2015 Jan;59(1):129-35. doi: 10.1128/AAC.03822-14. Epub 2014 Oct 20.
Upton AM, Cho S, Yang TJ, Kim Y, Wang Y, Lu Y, Wang B, Xu J, Mdluli K, Ma Z, Franzblau SG. In vitro and in vivo activities of the nitroimidazole TBA-354 against Mycobacterium tuberculosis. Antimicrob Agents Chemother. 2015 Jan;59(1):136-44. doi: 10.1128/AAC.03823-14. Epub 2014 Oct 20.
Matsumoto M, Hashizume H, Tomishige T, Kawasaki M, Tsubouchi H, Sasaki H, Shimokawa Y, Komatsu M. OPC-67683, a nitro-dihydro-imidazooxazole derivative with promising action against tuberculosis in vitro and in mice. PLoS Med. 2006 Nov;3(11):e466. doi: 10.1371/journal.pmed.0030466.
Zhang F, Li S, Wen S, Zhang T, Shang Y, Huo F, Xue Y, Li L, Pang Y. Comparison of in vitro Susceptibility of Mycobacteria Against PA-824 to Identify Key Residues of Ddn, the Deazoflavin-Dependent Nitroreductase from Mycobacterium tuberculosis. Infect Drug Resist. 2020 Mar 11;13:815-822. doi: 10.2147/IDR.S240716. eCollection 2020.
Stinson K, Kurepina N, Venter A, Fujiwara M, Kawasaki M, Timm J, Shashkina E, Kreiswirth BN, Liu Y, Matsumoto M, Geiter L. MIC of Delamanid (OPC-67683) against Mycobacterium tuberculosis Clinical Isolates and a Proposed Critical Concentration. Antimicrob Agents Chemother. 2016 May 23;60(6):3316-22. doi: 10.1128/AAC.03014-15. Print 2016 Jun.
Keller PM, Homke R, Ritter C, Valsesia G, Bloemberg GV, Bottger EC. Determination of MIC distribution and epidemiological cutoff values for bedaquiline and delamanid in Mycobacterium tuberculosis using the MGIT 960 system equipped with TB eXiST. Antimicrob Agents Chemother. 2015 Jul;59(7):4352-5. doi: 10.1128/AAC.00614-15. Epub 2015 May 4.
Liu Y, Matsumoto M, Ishida H, Ohguro K, Yoshitake M, Gupta R, Geiter L, Hafkin J. Delamanid: From discovery to its use for pulmonary multidrug-resistant tuberculosis (MDR-TB). Tuberculosis (Edinb). 2018 Jul;111:20-30. doi: 10.1016/j.tube.2018.04.008. Epub 2018 May 3.
Conradie F, Diacon AH, Ngubane N, Howell P, Everitt D, Crook AM, Mendel CM, Egizi E, Moreira J, Timm J, McHugh TD, Wills GH, Bateson A, Hunt R, Van Niekerk C, Li M, Olugbosi M, Spigelman M; Nix-TB Trial Team. Treatment of Highly Drug-Resistant Pulmonary Tuberculosis. N Engl J Med. 2020 Mar 5;382(10):893-902. doi: 10.1056/NEJMoa1901814.
Trebucq A, Schwoebel V, Kashongwe Z, Bakayoko A, Kuaban C, Noeske J, Hassane S, Souleymane B, Piubello A, Ciza F, Fikouma V, Gasana M, Ouedraogo M, Gninafon M, Van Deun A, Cirillo DM, Koura KG, Rieder HL. Treatment outcome with a short multidrug-resistant tuberculosis regimen in nine African countries. Int J Tuberc Lung Dis. 2018 Jan 1;22(1):17-25. doi: 10.5588/ijtld.17.0498. Epub 2017 Nov 17.
Other Identifiers
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YNLX-2024-009
Identifier Type: -
Identifier Source: org_study_id
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