Multidrug Resistant TuberculosisPhase 1NCT01856634
Pharmacokinetic and Safety Trial to Determine the Appropriate Dose for Pediatric Patients With Multidrug Resistant Tuberculosis
A Phase 1 study testing 100 mg Delamanid, 50 mg Delamanid and 25 mg Pediatric Formulation Delamanid in people with Multidrug Resistant Tuberculosis and Pediatric, run by Otsuka Pharmaceutical Development & Commercialization, Inc. at 2 sites in 2 countries.
Trial summary
The purpose of this trial is to determine the pediatric dose of delamanid that is equivalent to the adult dose already shown to be effective against multidrug-resistant tuberculosis. Read more about this study
- Who is it for?
- Ages Up to 17 years
- Conditions the study is for
- Multidrug Resistant Tuberculosis, Pediatric
- What is being tested?
- 100 mg Delamanid, 50 mg Delamanid and 25 mg Pediatric Formulation Delamanid
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 37 participants
- Where
- 2 sitesin 2 countries
- Study dates
- 14 Jun 2013to 28 Dec 2017
- Phase
- Phase 1
- Are there results?
- None posted in the registry
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 Up to 17 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Confirmed diagnosis of MDR-TB OR
- Presumptive diagnosis of MDR-TB including one of the following:
- Clinical specimen suggestive of TB
- Persistent cough lasting > 2 weeks
- Fever, weight loss, and failure to thrive
- Findings on recent chest radiograph (prior to Visit 1) consistent with TB AND
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- Household contact of a person with known MDR-TB or a person who died while appropriately taking drugs for sensitive TB OR
- On first-line TB treatment but with no clinical improvement
- Negative urine pregnancy test for female patients who have reached menarche
- Written informed consent/assent
Who cannot join
- Laboratory evidence of active hepatitis B or C
- Children with body weight < 5.5 kg
- For patients with HIV co-infection, CD4 cell count ≤ 1000/mm3 for children 1-5 years old, and ≤ 1500/mm3 for children less than 1 year old
- History of allergy to metronidazole and any disease or condition in which metronidazole is required
- Use of amiodarone within 12 months or use of other predefined antiarrhythmic medications within 30 days prior to first dose of delamanid
- Serious concomitant conditions
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- Preexisting cardiac conditions
- Abnormalities in Screening ECG (including AV block, BBB or hemi-block, QRS prolongation > 120 msec, or QTcF > 450 msec in both males and females)
- Concomitant condition such as renal impairment characterized by serum creatinine levels >1.5 mg/dL, hepatic impairment (ALT or AST > 3x ULN), or hyperbilirubinemia characterized by total bilirubin > 2x ULN
- Current diagnosis of severe malnutrition or kwashiorkor
- Positive urine drug screen (Groups 1 and 2 only)
- Rifampicin and/or moxifloxacin within 1 week prior to the first dose of delamanid and/or any prior or concurrent use of bedaquiline
- Lansky Play Performance Score < 50 (not applicable for children < 1 year old) or Karnofsky Score < 50
- Administered an IMP within 1 month prior to Visit 1
- Pregnant, breast-feeding, or planning to conceive or father a child within the timeframe described in the information consent form (Groups 1 and 2 only)
Trial locations and contacts
2 sites in 2 countries.
2 sites in 2 countries
Philippines1 site
De La Salle Health Sciences Institute
Dasmariñas, Cavite, 4114
About this study
Official title: Phase 1, Open-label, Multiple-dose, and Age De-escalation Trial to Assess the Pharmacokinetics, Safety and Tolerability of Delamanid (OPC 67683) in Pediatric Multidrug-resistant Tuberculosis Patients on Therapy With an Optimized Background Regimen of Anti-tuberculosis Drugs
The purpose of this trial is to determine the pediatric dose of delamanid that is equivalent to the adult dose already shown to be effective against multidrug-resistant tuberculosis.
Read the detailed description
This trial will investigate the pharmacokinetics (PK) and safety of delamanid administered for 10 days to pediatric patients aged birth to 17 years who are also on therapy with an optimized background regimen. The purpose of the trial is to determine which dose in pediatric MDR-TB patients will result in delamanid plasma exposure similar to efficacious plasma exposure in adult MDR-TB patients. This is an age de-escalation trial in four groups:
Group 1: 12 to 17 years (100 mg BID; n=6) Group 2: 6 to 11 years (50 mg BID; n=6) Group 3: 3 to 5 years (25 mg BID; n=12) Group 4: Birth to 2 years (Dose based on patient's body weight, n=12)
- Patients > 10 kg will receive 10 mg BID
- Patients > 8 kg and ≤ 10 kg will receive 5 mg BID
- Patient ≤ to 8 kg will receive 5 mg QD
- Conditions
- Multidrug Resistant Tuberculosis, Pediatric
- Being tested
- 100 mg Delamanid, 50 mg Delamanid, 25 mg Pediatric Formulation Delamanid, 10 mg Delamanid Pediatric Formulation, 5 mg Delamanid Pediatric Formulation
- Keywords
- Tuberculosis, Tuberculosis, Multidrug-Resistant, Mycobacterium Infections, Actinomycetales Infections, Gram-Positive Infections, Bacterial Infections, Pediatric
- Medical subject headings
- Tuberculosis, Multidrug-Resistant, Tuberculosis, Mycobacterium Infections, Actinomycetales Infections, Bacterial Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
100 mg DelamanidDrug
Also called OPC-67683
100 mg Delamanid BID for 10 days
50 mg DelamanidDrug
Also called OPC-67683
50 mg Delamanid BID for 10 days
25 mg Pediatric Formulation DelamanidDrug
Also called DPF
25 mg Pediatric Formulation Delamanid BID for 10 days
10 mg Delamanid Pediatric FormulationDrug
Also called DPF
Patients > 10 kg will receive DPF 10 mg BID for 10 days
5 mg Delamanid Pediatric FormulationDrug
Also called DPF
Patients > 8 kg and ≤ 10 kg will receive DPF 5 mg BID for 10 days
Patients ≤ 8 kg will receive DPF 5 mg QD for 10 days
Optimized Background RegimenDrug
Also called OBR
Selection and administration of the treatment medications (i.e. OBRs) will be based on WHO's Guidelines for the programmatic management of drug-resistant TB, in conjunction with national TB program guidelines in each country
| Study group | Role | What they receive |
|---|---|---|
| Group 1: 12 to 17 years of age | Experimental | Group 1: 100 mg Delamanid BID for 10 days + OBR Receives: Drug: 100 mg Delamanid; Drug: Optimized Background Regimen |
| Group 2: 6 to 11 years of age | Experimental | 50 mg Delamanid BID for 10 days + OBR Receives: Drug: 50 mg Delamanid; Drug: Optimized Background Regimen |
| Group 3: 3 to 5 years of age | Experimental | 25 mg Pediatric Formulation Delamanid BID for 10 days + OBR Receives: Drug: 25 mg Pediatric Formulation Delamanid; Drug: Optimized Background Regimen |
| Group 4: Birth to 2 years of age | Experimental | Delamanid Pediatric Formulation (DPF) for 10 days + OBR. DPF dose based on patient's body weight during baseline visit:
* Patient's > 10 kg will receive DPF 10 mg BID + OBR
* Patient's > 8 kg and ≤ 10 kg will receive DPF 5 mg BID + OBR
* Patients ≤ 8 kg will receive DPF 5 mg QD + OBR Receives: Drug: 10 mg Delamanid Pediatric Formulation; Drug: 5 mg Delamanid Pediatric Formulation; Drug: Optimized Background Regimen |
What is being measured
The primary outcome is the main question the study is designed to answer.
Plasma Concentrations
Plasma concentrations (Cmax, tmax, AUC 0-24h, accumulation ratio, apparent terminal elimination half-life, apparent total clearance) of delamanid and its metabolites on Days 1, 2, 10, 11, 13 (Groups 1 and 2 only), 15, 18.
Measured: Days 1, 2, 10, 11, 13 (Groups 1 and 2 only), 15, 18
Secondary outcomes (3)
Adverse Events
Number of reported adverse events
Measured: 40 Days
Safety Summary
Summary statistics of subjects with clinically significant abnormal laboratory test results, vitals, ECGs
Measured: 40 Days
Palatability of the Pediatric Formulation
Palatability of the pediatric formulation will be assessed using an age-appropriate visual hedonic scale and clinical assessment for Groups 3 and 4 only.
Measured: Days 1 and 10
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 May 2013 (estimated)
- Study start14 Jun 2013
- Primary completion10 Dec 2017
- Study completion28 Dec 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Multidrug Resistant TuberculosisStudies of the same condition, open and under way.
- More trials run by Otsuka Pharmaceutical Development & Commercialization, Inc.The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 37 participants (actual)
Sponsor and investigators
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Jeffrey Hafkin, MD, Study director, Otsuka Pharmaceutical Development & Commercialization, Inc.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01856634
- Sponsor's protocol ID
- 242-12-232
- Status last verified
- Jan 2018
- First submitted
- 15 May 2013
- Last updated
- 30 Jan 2018
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Garcia-Prats AJ, Frias M, van der Laan L, De Leon A, Gler MT, Schaaf HS, Hesseling AC, Malikaarjun S, Hafkin J. Delamanid Added to an Optimized Background Regimen in Children with Multidrug-Resistant Tuberculosis: Results of a Phase I/II Clinical Trial. Antimicrob Agents Chemother. 2022 May 17;66(5):e0214421. doi: 10.1128/aac.02144-21. Epub 2022 Apr 11.
PubMed 35404075
Study at a glance
From the registry record, last updated by the sponsor on 30 Jan 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase 1, Open-label, Multiple-dose, and Age De-escalation Trial to Assess the Pharmacokinetics, Safety and Tolerability of Delamanid (OPC 67683) in Pediatric Multidrug-resistant Tuberculosis Patients on Therapy With an Optimized Background Regimen of Anti-tuberculosis Drugs
- ClinicalTrials.gov ID
- NCT01856634
- Acronym / sponsor ID
- 242-12-232
- Conditions
- Multidrug Resistant Tuberculosis, Pediatric
- Keywords
- Tuberculosis, Tuberculosis, Multidrug-Resistant, Mycobacterium Infections, Actinomycetales Infections, Gram-Positive Infections, Bacterial Infections, Pediatric
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 37 participants (actual)
- Lead sponsor
- Otsuka Pharmaceutical Development & Commercialization, Inc.Industry (pharma, biotech, devices)
- Study start
- 14 Jun 2013 (actual)
- Primary completion
- 10 Dec 2017 (actual)
- Study completion
- 28 Dec 2017 (actual)
- First posted
- 17 May 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this trial is to determine the pediatric dose of delamanid that is equivalent to the adult dose already shown to be effective against multidrug-resistant tuberculosis.
Detailed description
This trial will investigate the pharmacokinetics (PK) and safety of delamanid administered for 10 days to pediatric patients aged birth to 17 years who are also on therapy with an optimized background regimen. The purpose of the trial is to determine which dose in pediatric MDR-TB patients will result in delamanid plasma exposure similar to efficacious plasma exposure in adult MDR-TB patients. This is an age de-escalation trial in four groups:
Group 1: 12 to 17 years (100 mg BID; n=6) Group 2: 6 to 11 years (50 mg BID; n=6) Group 3: 3 to 5 years (25 mg BID; n=12) Group 4: Birth to 2 years (Dose based on patient's body weight, n=12)
- Patients > 10 kg will receive 10 mg BID
- Patients > 8 kg and ≤ 10 kg will receive 5 mg BID
- Patient ≤ to 8 kg will receive 5 mg QD
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Group 1: 12 to 17 years of age | Experimental | Drug: 100 mg Delamanid, Drug: Optimized Background RegimenGroup 1: 100 mg Delamanid BID for 10 days + OBR |
| Group 2: 6 to 11 years of age | Experimental | Drug: 50 mg Delamanid, Drug: Optimized Background Regimen50 mg Delamanid BID for 10 days + OBR |
| Group 3: 3 to 5 years of age | Experimental | Drug: 25 mg Pediatric Formulation Delamanid, Drug: Optimized Background Regimen25 mg Pediatric Formulation Delamanid BID for 10 days + OBR |
| Group 4: Birth to 2 years of age | Experimental | Drug: 10 mg Delamanid Pediatric Formulation, Drug: 5 mg Delamanid Pediatric Formulation, Drug: Optimized Background RegimenDelamanid Pediatric Formulation (DPF) for 10 days + OBR. DPF dose based on patient's body weight during baseline visit: * Patient's > 10 kg will receive DPF 10 mg BID + OBR * Patient's > 8 kg and ≤ 10 kg will receive DPF 5 mg BID + OBR * Patients ≤ 8 kg will receive DPF 5 mg QD + OBR |
Who may qualify
- Ages
- Up to 17 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (10 listed)
- Confirmed diagnosis of MDR-TB OR
- Presumptive diagnosis of MDR-TB including one of the following:
- Negative urine pregnancy test for female patients who have reached menarche
- Written informed consent/assent
Key exclusion criteria (15 listed)
- Laboratory evidence of active hepatitis B or C
- Children with body weight < 5.5 kg
- For patients with HIV co-infection, CD4 cell count ≤ 1000/mm3 for children 1-5 years old, and ≤ 1500/mm3 for children less than 1 year old
- History of allergy to metronidazole and any disease or condition in which metronidazole is required
- Use of amiodarone within 12 months or use of other predefined antiarrhythmic medications within 30 days prior to first dose of delamanid
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| 100 mg DelamanidAlso: OPC-67683100 mg Delamanid BID for 10 days | Drug | Group 1: 12 to 17 years of age |
| 50 mg DelamanidAlso: OPC-6768350 mg Delamanid BID for 10 days | Drug | Group 2: 6 to 11 years of age |
| 25 mg Pediatric Formulation DelamanidAlso: DPF25 mg Pediatric Formulation Delamanid BID for 10 days | Drug | Group 3: 3 to 5 years of age |
| 10 mg Delamanid Pediatric FormulationAlso: DPFPatients > 10 kg will receive DPF 10 mg BID for 10 days | Drug | Group 4: Birth to 2 years of age |
| 5 mg Delamanid Pediatric FormulationAlso: DPFPatients > 8 kg and ≤ 10 kg will receive DPF 5 mg BID for 10 days Patients ≤ 8 kg will receive DPF 5 mg QD for 10 days | Drug | Group 4: Birth to 2 years of age |
| Optimized Background RegimenAlso: OBRSelection and administration of the treatment medications (i.e. OBRs) will be based on WHO's Guidelines for the programmatic management of drug-resistant TB, in conjunction with national TB program guidelines in each country | Drug | Group 1: 12 to 17 years of age, Group 2: 6 to 11 years of age, Group 3: 3 to 5 years of age, Group 4: Birth to 2 years of age |
Primary outcome
Plasma Concentrations
Time frame: Days 1, 2, 10, 11, 13 (Groups 1 and 2 only), 15, 18
Plasma concentrations (Cmax, tmax, AUC 0-24h, accumulation ratio, apparent terminal elimination half-life, apparent total clearance) of delamanid and its metabolites on Days 1, 2, 10, 11, 13 (Groups 1 and 2 only), 15, 18.
3 secondary outcomes
Adverse Events
Time frame: 40 Days
Safety Summary
Time frame: 40 Days
Palatability of the Pediatric Formulation
Time frame: Days 1 and 10
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jan 2018.
- Derived from this study: PubMed 35404075Garcia-Prats AJ, Frias M, van der Laan L, De Leon A, Gler MT, Schaaf HS, Hesseling AC, Malikaarjun S, Hafkin J. Delamanid Added to an Optimized Background Regimen in Children with Multidrug-Resistant Tuberculosis: Results of a Phase I/II Clinical Trial. Antimicrob Agents Chemother. 2022 May 17;66(5):e0214421. doi: 10.1128/aac.02144-21. Epub 2022 Apr 11.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jeffrey Hafkin, MD study director
Otsuka Pharmaceutical Development & Commercialization, Inc.
2 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing 100 mg Delamanid, 50 mg Delamanid and 25 mg Pediatric Formulation Delamanid in people with Multidrug Resistant Tuberculosis and Pediatric, run by Otsuka Pharmaceutical Development & Commercialization, Inc. at 2 sites in 2 countries.
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 10 inclusion and 15 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: finished, as of the sponsor's last update on 30 Jan 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Philippines, South Africa. 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 phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Plasma Concentrations (time frame: Days 1, 2, 10, 11, 13 (Groups 1 and 2 only), 15, 18). 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 NCT01856634, 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 30 Jan 2018.