Short Course Regimen in Low Risk Active Tuberculosis- a Multicenter, Randomized, Active-controlled, Trial

NCT ID: NCT06727864

Last Updated: 2025-03-25

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

PHASE3

Total Enrollment

270 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-01

Study Completion Date

2028-12-31

Brief Summary

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Tuberculosis remains an important global health problem, and the world is currently not on track to end the TB epidemic by 2030. With the concerted efforts of the government and medical community, the incidence of TB in Taiwan has gradually decreased, however, Taiwan remains an endemic area for TB. The development of efficacious, safe, and shorter treatment regimens could significantly improve treatment completion rate and reduce transmission of TB. The current treatment guidelines for drug-susceptible TB from the World Health Organization (WHO), American Thoracic Society (ATS), United States Center for Diseases Control (U.S. CDC), Infectious Diseases Society of America (IDSA) and European Respiratory Society (ERS) include 2 months of isoniazid, rifampin, pyrazinamide and ethambutol (HREZ), followed by 4 months of isoniazid, rifampin, and ethambutol(HRE). The current treatment regimen requires 6 months of treatment, despite being highly efficacious, requires long duration of treatment. Adherence to treatment is the major barrier which poses a negative impact to TB control, and increased cost to both the patient and the public health system. Developing an efficacious, safe and short treatment regimen can significantly improve TB management and treatment success rates.

Detailed Description

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This prospective, multicenter, randomized, open-labeled 3-year study, will recruit 270 adult patients with newly diagnosed tuberculosis with low risk of recurrence, and randomized 1:1 to a 4 months 2HREZ/2HRE (n=135) versus standard, 6 months regimen 2HREZ/4HRE (n=135). Expected enrollment will be 90 patients in year 1, 90 in year 2 and 90 in year 3.

This study aims to evaluate the efficacy, safety and long-term recurrence rate of a short-course, 4-months regimen including 2HREZ/2HRE compared with the standard 6-months regimen, 2HREZ/4HRE, and the impact of short regimen on reducing the costs and loading to the public health and medical system

Conditions

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Pulmonary Tuberculosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two months of isoniazid (H), pyrazinamide (Z), rifampicin (R), and pyrazinamide (Z) Subsequent orders are for H(E)Z for another two months
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Masking will not be done

Study Groups

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Intervention/Treatment

Two months of isoniazid (H), ethambutol (E), rifampicin (R) and Pyrazinamide (Z) followed by HR(E) for another two months

Group Type EXPERIMENTAL

4-month regimen (2HERZ/2HRE)

Intervention Type DRUG

4-month (2HERZ/2HRE)

6-months HERZ (2HERZ/4HRE)

Two months of isoniazid (H), pyrazinamide (Z), rifampicin (R) and Pyrazinamide (Z) followed by HR(E) for another four months

Group Type ACTIVE_COMPARATOR

6-month (2HERZ/4HRE)

Intervention Type DRUG

2 months of HREZ followed by 4 months of HR/HRE

Interventions

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4-month regimen (2HERZ/2HRE)

4-month (2HERZ/2HRE)

Intervention Type DRUG

6-month (2HERZ/4HRE)

2 months of HREZ followed by 4 months of HR/HRE

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Newly diagnosed pulmonary tuberculosis patients combined with any of the following diagnostic conditions:

* at least one set of sputum specimens is positive for Mycobacterium tuberculosis culture or TB PCR test; or
* pathological and histological findings of typical tuberculosis manifestations;
* clinical diagnosis and Physician determines the need for complete anti-tuberculosis treatment
* Those who have had tuberculosis in the past and have been cured for at least three years can be included
* Aged over 20 years old
* Laboratory data at the time of inclusion in the study or within 14 days:

* Serum or plasma glutamic acid pyruvate transaminase (ALT) value ≦ three times the upper limit of normal
* Serum or plasma total bilirubin ≦ 2.5 times the upper limit of normal
* Serum or plasma creatinine ≦ twice the upper limit of normal or creatinine clearance greater than 30 mL/min
* Heme ≧7.0 g/Dl
* Platelets ≧100,000/mm3
* Patient signs consent form
* Patients who agree to join and cooperate with the county and city health bureau's urban treatment plan to ensure medication compliance.

Exclusion Criteria

* The acid-fast smear of sputum or respiratory specimen is strongly positive (≥ 2+)
* Chest X-ray or lung computed tomography combined with open lesions
* Chest X-ray or lung computed tomography shows extensive lesions and the clinician judges that short-term treatment is not suitable
* Simultaneous combination of intrapulmonary and extrapulmonary tuberculosis
* People who are unable to take oral medications
* People who have participated in this research
* Have used anti-tuberculosis drugs for more than 14 days
* A history of tuberculosis suspected or diagnosed as central nervous system tuberculosis, bone or joint tuberculosis, miliary tuberculosis or tuberculous pericarditis.
* Known history of allergy or intolerance to this study drug
* Patients with HIV infection, organ transplantation, and chronic renal failure
* Long-term use of immunosuppressive drugs, including steroid use \>10mg/day (more than 30 consecutive days in the last three months)
* Late exclusion: Mycobacterium tuberculosis is known to be resistant to any one or more of the following drugs: rifampin, isoniazid, ethambutol
Minimum Eligible Age

20 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Taipei Veterans General Hospital, Taiwan

OTHER_GOV

Sponsor Role collaborator

National Taiwan University Hospital

OTHER

Sponsor Role collaborator

Chang Gung Memorial Hospital

OTHER

Sponsor Role collaborator

Far Eastern Memorial Hospital

OTHER

Sponsor Role collaborator

E-DA Hospital

OTHER

Sponsor Role collaborator

Kaohsiung Medical University

OTHER

Sponsor Role collaborator

Kaohsiung Veterans General Hospital.

OTHER

Sponsor Role lead

Responsible Party

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Susan Shin-Jung Lee

Attending physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Susan Shin-Jung Lee, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Kaohsiung Veterans General Hospital.

Locations

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Far Eastern Memorial Hospital

New Taipei City, Bangiao, Taiwan

Site Status RECRUITING

Taichung Hospital

Taichung, West, Taiwan

Site Status RECRUITING

E-DA Healthcare Group

Kaoshiung, Yanchao, Taiwan

Site Status RECRUITING

Kaohsiung Medical University Chung-Ho Memorial Hospital

Kaohsiung City, , Taiwan

Site Status RECRUITING

Kaohsiung Veterans General Hospital

Kaohsiung City, , Taiwan

Site Status RECRUITING

Taipei Veterans General Hospital

Taipei, , Taiwan

Site Status RECRUITING

National Taiwan University Hospital

Taipei, , Taiwan

Site Status RECRUITING

Linkou Chang Gung Memorial Hospital

Taoyuan, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Susan Shin-Jung Lee, M.D., Ph.D.

Role: CONTACT

+886-7342-2121 ext. 72029

Mei-Ling Lin, University

Role: CONTACT

+886-7342-2121 ext. 72062

Facility Contacts

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Wang Ping-Huai PhD, PhD

Role: primary

02-9866-7000 ext. 02-9866-7000

Huang Jhong-Ru PhD, PhD

Role: primary

04-222294411 ext. 04-222294411

Lee Ho-Sheng PhD, PhD

Role: primary

07-6150011 ext. 07-6150011

Chau-Chyun Sheu, M.D. Ph.D.

Role: primary

+886-7312-1101

Susan Shin-Jung Lee, M.D., Ph.D.

Role: primary

+886-7342-2121 ext. 2029

Hsin-Wei Tung, R.N.

Role: backup

+886-73422121 ext. 2062

Jia-Yih Feng, M.D.

Role: primary

+886-2871-2121 ext. 7564

Chin-Chung Shu, M.D.

Role: primary

+886-2312-3456 ext. 65132

Tsai-Yu Wang, M.D.

Role: primary

+886-3-3281200 ext. 8470

Other Identifiers

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KSVGH24-CT2-16

Identifier Type: -

Identifier Source: org_study_id

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