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Tuberculosis, PulmonaryPhase 2/3ORIENTNCT05401071

Optimizing(O) RIfapentine-based(RI) Regimen and shortENing(EN) the Treatment of Drug-sensitive Tuberculosis(T)

A Phase 2/3 study testing Short Regimen with Rifapentine 10mg/kg, Standardized Regimen and Short Regimen with Rifapentine 15mg/kg in people with Tuberculosis, Pulmonary, run by Huashan Hospital at 6 sites in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Tuberculosis (TB) remains the most important infectious disease in the world. A major barrier to tuberculosis control is poor adherence to long-term and complex treatment regimens. This is a multicenter prospective, non-inferiority randomized controlled study. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Tuberculosis, Pulmonary
What is being tested?
Short Regimen with Rifapentine 10mg/kg, Standardized Regimen and Short Regimen with Rifapentine 15mg/kg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,442 participants
Where
6 sitesChina
Study dates
13 Jan 2023to 1 Nov 2027
Phase
Phase 2/3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Age between 18 to 60 years;
  • Weight between 40 to 80 kg;
  • Individuals with smear-positive pulmonary tuberculosis and sensitive to rifampicin ;
  • Willing to provide signed informed consent, or parental consent and participant assent.
  • If you are a non-menopausal woman, agree to use or have used effective contraception during treatment.

Who cannot join

  • Combined extrapulmonary tuberculosis;
  • Patients with extensive lesion (extent of disease greater than 50% or cavity size greater than 4cm) ;
  • Individuals will be excluded from enrollment if, at the time of enrollment, their M. tuberculosis isolate is already known to be resistant to any one or more of the following: rifampin, isoniazid, pyrazinamide, ethambutol, or fluoroquinolones;
  • Alcohol abuse#drinking more than 64g of ethanol a day for male, 42g for female#;
  • Hemoglobin is less than 70g/L or platelet is less than 100*10^9/L;
  • Patients with impaired liver function (hepatic encephalopathy, ascites; total bilirubin is higher than the upper limit of normal; Alanine aminotransferase or aspartate aminotransferase is higher than the upper limit of normal);
Show all 13Show fewer
  • Blood creatinine is more than 1.5 times the upper limit of normal;
  • More than five days of systemic treatment with any one or more of the following drugs within 6 months preceding initiation of study drugs: isoniazid, rifampin, rifabutin, rifapentine, ethambutol, pyrazinamide, kanamycin, amikacin, streptomycin, capreomycin, moxifloxacin, levofloxacin, gatifloxacin, ofloxacin, ciprofloxacin, other fluoroquinolones, ethionamide, prothionamide, cycloserine, terizidone, para-aminosalicylic acid, linezolid, clofazimine, delamanid or bedaquiline;
  • Known history of prolonged QT syndrome;
  • Current or planned use within six months following enrollment of one or more of the following medications: HIV protease inhibitors, HIV integrase inhibitors, HIV entry and fusion inhibitors, HIV non-nucleoside reverse transcriptase inhibitors other than efavirenz; quinidine, procainamide, amiodarone, sotalol, disopyramide, ziprasidone, or terfenadine;
  • Known allergy or intolerance to any of the study medications;
  • AIDS patients;
  • Pregnant or breast-feeding.

Trial locations and contacts

6 sites in 1 country. Contact the study team or a site near you to ask about taking part.

6 sites in 1 country

China6 sites, 6 recruiting
  • Guiyang Public Health Clinical Center

    Guiyang, Guizhou

    Cui Cai

    Not yet recruiting
  • People's Hospital of Qiandongnan

    Kaili, Guizhou

    Jing Wang

    Not yet recruiting
  • The Third People's Hospital of Liupanshui

    Liupanshui, Guizhou

    Chunlong Zhang

    Not yet recruiting
  • Department of Infectious Disease, Huashan Hospital

    Shanghai, Shanghai Municipality, 200040

    Hongyu Wang, 17717366509, rubywang961208@gmail.com

    Recruiting
  • People's Hospital of Zhuji, Zhejiang Province

    Zhuji, Zhejiang, 311899

    Heqing Huang, 13858516315, zjganran@163.com

    Not yet recruiting
  • Affiliated Hospital of Zunyi Medical University

    Zunyi, Guizhou

    Jianyong Zhang

    Not yet recruiting

Other trials in China

About this study

Official title: Efficacy and Safety of Short-course Treatment for Drug-sensitive Tuberculosis in China

Tuberculosis (TB) remains the most important infectious disease in the world. A major barrier to tuberculosis control is poor adherence to long-term and complex treatment regimens.

This is a multicenter prospective, non-inferiority randomized controlled study. The purpose of our study is a) to evaluate the tolerability, efficacy and pharmacokinetics/pharmacodynamics (PK/PD) of the high-dose rifapentine, b) to evaluate whether the high-dose rifapentine-containing regimen has the potential to treat the rifampicin-sensitive pulmonary tuberculosis and shorten the course of treatment to 17 weeks. This study is of great significance for shortening the course of treatment, reducing the adverse reactions and economic burden of patients' treatment in rifampicin-sensitive tuberculosis patient.

Read the detailed description

Tuberculosis (TB) remains the most important infectious disease in the world. A major barrier to tuberculosis control is poor adherence to long-term and complex treatment regimens. Incomplete TB treatment can lead to increased morbidity and mortality, prolonged infectivity and transmission, and the development of drug resistance. The development of new therapeutic strategies with stronger bactericidal activity could lead to shorter and better-tolerated regimens, thereby increasing cure rates, lowering costs, potentially reducing transmission and preventing the emergence of multidrug-resistant tuberculosis (MDR-TB).

This trial is a multicenter prospective, non-inferiority randomized controlled study. Rifampicin-sensitive pulmonary tuberculosis patients will be included in our study. Stage 1 of the study is designed to evaluate the tolerability, efficacy and PK/PD of the high-dose rifapentine in order to select two doses to carry forward into study Stage 2. Study Stage 2 will provide pivotal confirmation of efficacy, safety, and tolerability of the selected rifapentine doses in patients with rifampicin-sensitive pulmonary tuberculosis.

Being tested
Short Regimen with Rifapentine 10mg/kg, Standardized Regimen, Short Regimen with Rifapentine 15mg/kg, Short Regimen with Rifapentine 20mg/kg
Keywords
rifapentine, shorter treatment, pulmonary tuberculosis
Medical subject headings
Tuberculosis, Pulmonary

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Short Regimen with Rifapentine 10mg/kgOther

    rifapentine 10mg/kg daily; isoniazid 300mg daily; pyrazinamide ≤50kg 1000mg daily, 50-71kg 1200mg daily, >71kg 1000mg daily; moxifloxacin 400mg daily. All treatment is taken orally.

  • Standardized RegimenCombination product

    During the intensive phase, rifampicin ≤55kg 450mg daily, 55-71kg 600mg daily, >71kg 750mg daily; isoniazid ≤55kg 225mg daily, 55-71kg 300mg daily, >71kg 375mg daily; pyrazinamide ≤55kg 900mg daily, 55-71kg 1200mg daily, >71kg 1600mg daily; ethambutol ≤55kg 825mg daily, 55-71kg 1100mg daily, >71kg 1375mg daily; All treatment is taken orally.

    During the continuation phase, rifampicin ≤50kg 450mg daily, >50kg 600mg daily; isoniazid 300mg daily; All treatment is taken orally.

  • Short Regimen with Rifapentine 15mg/kgOther

    rifapentine 15mg/kg daily; isoniazid 300mg daily; pyrazinamide ≤50kg 1000mg daily, 50-71kg 1200mg daily, >71kg 1000mg daily; moxifloxacin 400mg daily. All treatment is taken orally.

  • Short Regimen with Rifapentine 20mg/kgOther

    rifapentine 20mg/kg daily; isoniazid 300mg daily; pyrazinamide ≤50kg 1000mg daily, 50-71kg 1200mg daily, >71kg 1000mg daily; moxifloxacin 400mg daily. All treatment is taken orally.

Study groups in NCT05401071
Study groupRoleWhat they receive
Short Regimen with Rifapentine 10mg/kgExperimentalIntervention: Short Regimen with Rifapentine 10mg/kg consists of two periods of 17- 26 weeks. The first is an intensive phase of 8 weeks, and included rifapentine, isoniazid, pyrazinamide, and moxifloxacin. This is followed by a continuation phase of 9 weeks with the following agents: rifapentine, isoniazid and moxifloxacin (extended up a maximum of 18 weeks if no smear conversion at the end of 8 weeks or the tuberculosis cavity is not closed at the end of 17 weeks).
Receives: Other: Short Regimen with Rifapentine 10mg/kg
Short Regimen with Rifapentine 15mg/kgExperimentalIntervention: Short Regimen with Rifapentine 15mg/kg consists of two periods of 17- 26 weeks. The first is an intensive phase of 8 weeks, and included rifapentine, isoniazid, pyrazinamide, and moxifloxacin. This is followed by a continuation phase of 9 weeks with the following agents: rifapentine, isoniazid and moxifloxacin (extended up a maximum of 18 weeks if no smear conversion at the end of 8 weeks or the tuberculosis cavity is not closed at the end of 17 weeks).
Receives: Other: Short Regimen with Rifapentine 15mg/kg
Standardized RegimenActive comparatorIntervention:World Health Organization (WHO) Standardized Regimen group consists of 26 weeks with two phases of treatment. The first is an intensive phase of 8 weeks, and included rifampicin, isoniazid, pyrazinamide, and ethambutol. This is followed by a continuation phase of 18 weeks with the following agents: rifampicin and isoniazid.
Receives: Combination Product: Standardized Regimen
Short Regimen with Rifapentine 20mg/kgExperimentalIntervention: Short Regimen with Rifapentine 20mg/kg consists of two periods of 17- 26 weeks. The first is an intensive phase of 8 weeks, and included rifapentine, isoniazid, pyrazinamide, and moxifloxacin. This is followed by a continuation phase of 9 weeks with the following agents: rifapentine, isoniazid and moxifloxacin (extended up a maximum of 18 weeks if no smear conversion at the end of 8 weeks or the tuberculosis cavity is not closed at the end of 17 weeks).
Receives: Other: Short Regimen with Rifapentine 20mg/kg

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Treatment success rate of the short regimen during drug treatment and follow-up.

    To compare the treatment success rate without relapse between the short regimen with rifapentine 10mg/kg, the short regimen with rifapentine 15mg/kg, the short regimen with rifapentine 20mg/kg and the WHO standardized regimen group.

    Measured: 108 weeks after randomization

Secondary outcomes (3)
  1. The frequency of grade 3 or greater adverse events among patients Over the 108 Week Treatment and Follow-up Period.

    To compare the proportion of patients who experience grade 3 or greater adverse events between the short regimen with rifapentine 10mg/kg, the short regimen with rifapentine 15mg/kg, the short regimen with rifapentine 20mg/kg and the WHO standardized regimen group.

    Measured: up to 108 weeks

  2. Relapse rate during follow-up.

    To compare the treatment success rate without relapse between the short regimen with rifapentine 10mg/kg, the short regimen with rifapentine 15mg/kg, the short regimen with rifapentine 20mg/kg and the WHO standardized regimen group.

    Measured: 82-91 weeks after the end of drug treatment.

  3. the percentage of participants found to be culture-negative at the end of intensive phase and the end of treatment phase

    To compare the percentage of participants found to be culture-negative at the end of intensive phase and the end of treatment phase between the short regimen with rifapentine 10mg/kg, the short regimen with rifapentine 15mg/kg, the short regimen with rifapentine 20mg/kg and the WHO standardized regimen group.

    Measured: 8 weeks, 17 weeks and 26 weeks after randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jun 2022
  2. Study start13 Jan 2023
  3. Primary completion1 Oct 2024 (estimated)
  4. Study completion1 Nov 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
2,442 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05401071
Sponsor's protocol ID
ORIENT
Acronym
ORIENT
Status last verified
Dec 2023
First submitted
27 Feb 2022
Last updated
11 Dec 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Feng Z, Miao Y, Peng Y, Sun F, Zhang Y, Li R, Ge S, Chen X, Song L, Li Y, Wang X, Zhang W. Optimizing (O) rifapentine-based (RI) regimen and shortening (EN) the treatment of drug-susceptible tuberculosis (T) (ORIENT) using an adaptive seamless design: study protocol of a multicenter randomized controlled trial. BMC Infect Dis. 2023 May 8;23(1):300. doi: 10.1186/s12879-023-08264-2.

    PubMed 37158831

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Short Regimen with Rifapentine 10mg/kg, Standardized Regimen and Short Regimen with Rifapentine 15mg/kg in people with Tuberculosis, Pulmonary, run by Huashan Hospital at 6 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 11 Dec 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Feng Sun, Dr. ((086)15921403893 ext. 8123, aaronsf1125@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Treatment success rate of the short regimen during drug treatment and follow-up. (time frame: 108 weeks after randomization). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05401071, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Dec 2023.

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