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

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-30

Study Completion Date

2026-06-30

Brief Summary

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The goal of this investigator initiated trial (IIT) is to learn if a 6-9months BDL regimen (bedaquiline plus delamanid plus linezolid)works to treat adults with multi-drug resistant tuberculosis or rifampicin-resistant pulmonary tuberculosis, in the context of Pretomanid not available in China. It will also learn about the safety of BDL regimen.

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.

Detailed Description

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Conditions

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Pulmonary Tuberculosis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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BDL interventionv group

Group Type EXPERIMENTAL

BDL regimen

Intervention Type DRUG

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

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* 1.A patient with multi-drug resistant/rifampicin-resistant pulmonary tuberculosis (MDR/RR-TB) with recent laboratory evidence (culture or molecular testing) within the last two months
* 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

* 1.According to DMID, peripheral neuropathy is classified as grade 3 or 4. Alternatively, participants with grade 1 or 2 neuropathy, which the investigator believes may progress/worsen during the study
* 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
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Public Health Clinical Medical Center of Chengdu

UNKNOWN

Sponsor Role collaborator

Wuhan Institute for Tuberculosis Control

OTHER

Sponsor Role collaborator

Changsha Central Hospital

OTHER

Sponsor Role collaborator

Anhui Chest Hospital

OTHER

Sponsor Role collaborator

Hunan Chest Hospital

UNKNOWN

Sponsor Role collaborator

Shandong Public Health Clinical Center

OTHER_GOV

Sponsor Role collaborator

Beijing Chest Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

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

Site Status NOT_YET_RECRUITING

Beijing Chest Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

Wuhan Institute for Tuberculosis Control

Wuhan, Hubei, China

Site Status NOT_YET_RECRUITING

Changsha Central Hospital

Changsha, Hunan, China

Site Status NOT_YET_RECRUITING

Hunan Chest Hospital

Changsha, Hunan, China

Site Status NOT_YET_RECRUITING

Shandong Public Health Clinical Center

Jinan, Shandong, China

Site Status NOT_YET_RECRUITING

Public Health Clinical Meadical Center of Chengdu

Chengdu, Sichuan, China

Site Status NOT_YET_RECRUITING

Countries

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China

Central Contacts

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Yuhong Liu, Ph.D

Role: CONTACT

86-13691187507

Wei Shu, Master

Role: CONTACT

86-18710016231

Facility Contacts

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Hua Wang

Role: primary

13395694530

Yuohong Liu, Doctor

Role: primary

13691187507

Wei Shu

Role: backup

Juan Du

Role: primary

Yi Pei

Role: primary

13755109302

Zhongheng Yi

Role: primary

13117318850

Yu Xiong

Role: primary

15589995880

Guihui Wu

Role: primary

13056668540

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.

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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.

Reference Type BACKGROUND
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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.

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Other Identifiers

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YNLX-2024-009

Identifier Type: -

Identifier Source: org_study_id

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