Multidrug- and Rifampicin-resistant TuberculosisPhase 4NCT05381194
BPaL(M) Regimen for the Treatment of MDR/RR-TB
A Phase 4 study testing BPaL(M) regimen in people with Multidrug- and Rifampicin-resistant Tuberculosis, run by Asan Medical Center at 1 site in South Korea.
Trial summary
The objective of this study is to analyze the efficacy of a new regimen using Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin for 24 weeks or Bedaquiline, Pretomanid, Linezolid for 26 weeks for the treatment of MDR/RR-TB through the clinical trial. Read more about this study
- Who is it for?
- Ages 19 years and older
- Conditions the study is for
- Multidrug- and Rifampicin-resistant Tuberculosis
- What is being tested?
- BPaL(M) regimen
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 80 participants
- Where
- 1 siteSouth Korea
- Study dates
- 13 Dec 2022to Dec 2027
- Phase
- Phase 4
- 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 19 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- At least 19 years old at enrolment
- Bodyweight over 35Kg
- If rifampicin resistance is confirmed through molecular or phenotypic drug susceptibility testing conducted on sputum or bronchoscopy specimens within 3 months of screening
- Chest radiological findings consistent with pulmonary tuberculosis
Who cannot join
- Uncontrolled DM
- Extrapulmonary TB that would require treatment longer than would be usual for pulmonary TB
- Less than 30 Karnofsky score at enrolment
- BMI less than 17
- Known severe allergy to any of the BPaLM regimen drugs
- Medical history of Glucose-galactose malabsorption, galactose intolerance, and Lapp lactase deficiency
Show all 23Show fewer
- HIV-positive
- The QTcF interval exceeds 450 msec on the electrocardiogram at baseline
- Patients who are at risk of Torsade de Pointes due to underlying heart diseases such as heart failure or arrhythmia
- For women of childbearing potential if the pregnancy test is positive, women who are breastfeeding or planning to become pregnant within 6 months of discontinuation/termination of treatment during the study, or who do not want contraception (i.e., oral and subcutaneous hormonal contraceptives, condoms, diaphragms, intrauterine device, or use of appropriate contraceptive methods including abstinence)
- Note: Double contraception (e.g., when a male uses a barrier contraceptive method such as a condom, a female partner uses a hormonal contraceptive or an additional contraceptive method such as an intrauterine device) is required while taking the study drug and up to 6 months after stopping/terminating the study drug. In particular, taking the study drug may affect the efficacy of hormonal contraceptives, and even if you are using only barrier contraception at the same time with your partner, you cannot be sure of preventing pregnancy, so it is necessary to maintain double contraception.
- Men who plan to become pregnant during the study period or within 6 months of discontinuation/termination of treatment, or who do not wish to use double contraception or abstinence during this period.
- Patients who have Grade 3 or 4 or higher peripheral neuritis, or Grade 1 or 2 with a high probability of progression to peripheral neuritis,
- Current use of monoamine oxidase Inhibitor or used 2 weeks before treatment
- Use of serotonergic antidepressant within 3 days of treatment
- Any contraindication that may affect QTc interval (amiodarone, chloroquine, chlorpromazine, clarithromycin, haloperidol, etc.)
- Any contraindication that may cause myelosuppression
- Taking drugs that affect the cytochrome P450 enzyme within 30 days (quinidine, tyramine, ketoconazole, fluconazole, testosterone, quinine, gestodene, metyrapone, phenelzine, doxorubicin, troleandomycin, cyclobenzaprine, erythromycin, cocaine, furafylline, cimetidine, dextromethorphan, etc.)
- Previously treated with Bedaquiline or Linezolid for more than 4 weeks
- Abnormal value of a blood test at baseline:
- Hypokalemia, Hemoglobin < 8.0 g/dL, Platelet < 75,000/mm3, ANC < 1000/mm3
- AST or ALT > 3 X ULN, Total bilirubin >2.0 X ULN, Albumin < 3.2 mg/dL
- Serum creatinine > 2 X ULN, Serum calcium < LLN, Serum magnesium < LLN
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
South Korea1 site, 1 recruiting
- Recruiting
Asan Medical Center
Seoul, Songpa-gu, 05505
Tae Sun Shim, MD, PhD, +82-2-3010-3892, shimts@amc.seoul.kr
About this study
Official title: The 6-month BPaL(M) Regimen for the Treatment of Patients With MDR/RR-TB: Multicenter, Single-arm, Operational Research, Clinical Trial
The objective of this study is to analyze the efficacy of a new regimen using Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin for 24 weeks or Bedaquiline, Pretomanid, Linezolid for 26 weeks for the treatment of MDR/RR-TB through the clinical trial.
Read the detailed description
The BPaL (Bedaquiline, Pretomanid, Linezolid) regimen has been proven effective for the treatment of Fluoroquinolone-resistant MDR-TB through studies such as the NixTB and ZeNix trials. In addition, the BPaLM regimen has been demonstrated to have excellent efficacy in RR-TB patients through the TB-PRACTECAL study. This study aims to analyze the efficacy of the BPaL(M) regimen in Korean MDR/RR-TB patients.
- Being tested
- BPaL(M) regimen
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
BPaL(M) regimenDrug
Patients diagnosed with MDR/RR-TB are initially assigned to the BPaLM regimen as a single-arm for treatment initiation. Afterward, if MDR/RR-TB is confirmed to be fluoroquinolone-resistant by molecular or phenotypic DST, the treatment is switched to the BPaL regimen (for 24 weeks). On the other hand, if MDR/RR-TB is confirmed to be fluoroquinolone-susceptible, treatment for MDR/RR-TB is maintained with the BPaLM regimen (for 26 weeks).
The dosage of each medication is as follows:
- Bedaquiline 400mg/day for the 2 weeks, 200mg/TIW afterward
- Pretomanid 200mg/day
- Linezolid 600mg/day for the 9weeks, 300mg/day afterward
- Moxifloxacin 400mg/day
| Study group | Role | What they receive |
|---|---|---|
| single arm (investigational arm) | Experimental | BPaLM Receives: Drug: BPaL(M) regimen |
What is being measured
The primary outcome is the main question the study is designed to answer.
A microbiological failure or clinical failure or relapse
A microbiological failure or clinical failure or relapse during the treatment period and the 12-month follow-up period after end of treatment
Measured: until 12 months after the end of treatment
Secondary outcomes (4)
Time to sputum culture conversion during the treatment period
Analyze the time to liquid and solid culture conversion and estimate the median value using the Kaplan-Meier Method
Measured: 26 weeks or 24 weeks
Proportion of culture-negative patients at specific times (weeks 4, 8, 12, 16, and 24 or 26)
Frequency analysis of liquid and solid culture conversion at a specific time point
Measured: 26 weeks or 24 weeks
Prescribed dose of Linezolid
Analyze the actual dose of linezolid prescribed
Measured: 26 weeks or 24 weeks
All-cause mortality
Analyze the frequency and fraction of deaths and estimate the median using the Kaplan-Meier Method
Measured: 26 weeks or 24 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 May 2022
- Study start13 Dec 2022
- Primary completionDec 2027 (estimated)
- Study completionDec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Multidrug- and Rifampicin-resistant TuberculosisStudies of the same condition, open and under way.
- More trials run by Asan Medical CenterThe 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 4
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 80 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Asan Medical Center
- Sponsor type
- University, hospital or other
- Collaborators
- Pusan National University Hospital, Samsung Medical Center, Seoul National University Hospital, Severance Hospital, Chonnam National University Hospital, The Catholic University of Korea, Chungbuk National University Hospital, Ulsan University Hospital, Soon Chun Hyang University, Incheon St.Mary's Hospital, DongGuk University, National Medical Center, Seoul
- Responsible party
- Principal investigator, Tae Sun Shim, Asan Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05381194
- Sponsor's protocol ID
- BPaL(M)
- Status last verified
- Mar 2024
- First submitted
- 8 May 2022
- Last updated
- 15 Mar 2024
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Mar 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The 6-month BPaL(M) Regimen for the Treatment of Patients With MDR/RR-TB: Multicenter, Single-arm, Operational Research, Clinical Trial
- ClinicalTrials.gov ID
- NCT05381194
- Acronym / sponsor ID
- BPaL(M)
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 80 participants (estimated)
- Lead sponsor
- Asan Medical CenterUniversity, hospital or other
- Collaborators
- Pusan National University Hospital, Samsung Medical Center, Seoul National University Hospital, Severance Hospital, Chonnam National University Hospital, The Catholic University of Korea, Chungbuk National University Hospital, Ulsan University Hospital, Soon Chun Hyang University, Incheon St.Mary's Hospital, DongGuk University, National Medical Center, Seoul
- Study start
- 13 Dec 2022 (actual)
- Primary completion
- Dec 2027 (estimated)
- Study completion
- Dec 2027 (estimated)
- First posted
- 19 May 2022 (actual)
- 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 objective of this study is to analyze the efficacy of a new regimen using Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin for 24 weeks or Bedaquiline, Pretomanid, Linezolid for 26 weeks for the treatment of MDR/RR-TB through the clinical trial.
Detailed description
The BPaL (Bedaquiline, Pretomanid, Linezolid) regimen has been proven effective for the treatment of Fluoroquinolone-resistant MDR-TB through studies such as the NixTB and ZeNix trials. In addition, the BPaLM regimen has been demonstrated to have excellent efficacy in RR-TB patients through the TB-PRACTECAL study. This study aims to analyze the efficacy of the BPaL(M) regimen in Korean MDR/RR-TB patients.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| single arm (investigational arm) | Experimental | Drug: BPaL(M) regimenBPaLM |
Who may qualify
- Ages
- 19 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- At least 19 years old at enrolment
- Bodyweight over 35Kg
- If rifampicin resistance is confirmed through molecular or phenotypic drug susceptibility testing conducted on sputum or bronchoscopy specimens within 3 months of screening
- Chest radiological findings consistent with pulmonary tuberculosis
Key exclusion criteria (23 listed)
- Uncontrolled DM
- Extrapulmonary TB that would require treatment longer than would be usual for pulmonary TB
- Less than 30 Karnofsky score at enrolment
- BMI less than 17
- Known severe allergy to any of the BPaLM regimen drugs
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 |
|---|---|---|
| BPaL(M) regimenPatients diagnosed with MDR/RR-TB are initially assigned to the BPaLM regimen as a single-arm for treatment initiation. Afterward, if MDR/RR-TB is confirmed to be fluoroquinolone-resistant by molecular or phenotypic DST, the treatment is switched to the BPaL regimen (for 24 weeks). On the other hand, if MDR/RR-TB is confirmed to be fluoroquinolone-susceptible, treatment for MDR/RR-TB is maintained with the BPaLM regimen (for 26 weeks). The dosage of each medication is as follows: * Bedaquiline 400mg/day for the 2 weeks, 200mg/TIW afterward * Pretomanid 200mg/day * Linezolid 600mg/day for the 9weeks, 300mg/day afterward * Moxifloxacin 400mg/day | Drug | single arm (investigational arm) |
Primary outcome
A microbiological failure or clinical failure or relapse
Time frame: until 12 months after the end of treatment
A microbiological failure or clinical failure or relapse during the treatment period and the 12-month follow-up period after end of treatment
4 secondary outcomes
Time to sputum culture conversion during the treatment period
Time frame: 26 weeks or 24 weeks
Proportion of culture-negative patients at specific times (weeks 4, 8, 12, 16, and 24 or 26)
Time frame: 26 weeks or 24 weeks
Prescribed dose of Linezolid
Time frame: 26 weeks or 24 weeks
All-cause mortality
Time frame: 26 weeks or 24 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Mar 2024.
- Individual participant dataSharing planned: No
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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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing BPaL(M) regimen in people with Multidrug- and Rifampicin-resistant Tuberculosis, run by Asan Medical Center at 1 site in South Korea.
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 4 inclusion and 23 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 15 Mar 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in South Korea. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
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 Tae Sun Shim, MD, PhD (+82-2-3010-3892, shimts@amc.seoul.kr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
A microbiological failure or clinical failure or relapse (time frame: until 12 months after the end of treatment). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 15 Mar 2024.