RECRUITING

Assessment of the Safety, Tolerability, and Effectiveness of Rifapentine Given Daily for LTBI

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This study is conducted to compare the safety and effectiveness of a novel short 6-week regimen of daily rifapentine (6wP, experimental arm) with a comparator arm of 12-16 weeks of rifamycin-based treatment (standard of care, control arm) of latent M. tuberculosis infection (LTBI). This trial is conducted among persons who are at increased risk of progression to tuberculosis (TB) and require treatment of LTBI. The study will be conducted in low, medium and high TB incidence settings that have treatment of LTBI as their standard of care and offer 12-16 week rifamycin-based therapy as standard of care. The hypothesis of this study is that the safety and effectiveness of the experimental treatment (6wP arm) is non-inferior to a comparator arm of 12-16 weeks of rifamycin-based treatment of LTBI (control arm). Participants are enrolled and randomly assigned to one of the two study arms: experimental 6wP or control. The comparator (control) arm's treatment regimens include 12 weeks of once-weekly isoniazid (INH) and rifapentine (3HP), 12 weeks of daily INH and rifampin (3HR), and 16 weeks of daily rifampin (4R). A total of 560 participants per arm (1,120 total) for the evaluation of safety and 1,700 participants per arm (3,400 total) for the evaluation of effectiveness will be enrolled, given treatment as per randomization assignment, and followed for 24 months from the date of enrollment. After completion of data collection, statistical analyses will be conducted to compare proportions of drug discontinuation due to adverse drug reaction (ADR) and proportions of newly diagnosed tuberculosis between 6wP and control arm.

Official Title

Six Weeks of Daily Rifapentine vs. a Comparator Arm of 12-16 Week Rifamycin-based Treatment of Latent M. Tuberculosis Infection: Assessment of Safety, Tolerability and Effectiveness

Quick Facts

Study Start:2019-08-01
Study Completion:2029-12
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT03474029

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:12 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD, ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Males or non-pregnant, non-breastfeeding females \> 12 years old. Women of child-bearing potential who are not surgically sterilized must agree to practice an adequate method of contraception (barrier method or non-hormonal intrauterine device) or abstain from heterosexual intercourse during study drug treatment.
  2. * Persons with LTBI who do not have evidence of TB disease and are at increased risk of progression to TB. M. tuberculosis infection may be demonstrated by either a positive tuberculin skin test (TST) or a positive interferon gamma release assay (IGRA; e.g., QuantiFERON or T.SPOT.TB). Persons with LTBI at increased risk of progression to TB are those with one of the following:
  3. 1. Household and other close contacts (\> 4 hours of exposure in a one week period) within 2 years prior to enrollment, of persons with culture-confirmed TB A positive nucleic acid amplification test (NAAT)/GeneXpert in the source case may be used for enrollment prior to culture confirmation
  4. 2. Recent M. tuberculosis infection, defined as converting from a documented negative to positive TST or IGRA within 2 years prior to enrollment. Persons without known close contact to someone with active pulmonary TB who have a conversion by IGRA may require additional evaluation to rule out a false conversion.
  5. 3. HIV co-infection (with CD4+ T-lymphocyte count \> 100 cells/mm3).
  6. 4. ≥ 2 cm2 of pulmonary parenchymal fibrosis on chest X-ray and no prior history of treatment for TB or LTBI.
  7. 5. Recent (within 3 years prior to enrollment) immigration to the United States or other country with low to moderate TB incidence, with abnormal chest X-ray, and no evidence of active TB.
  8. 6. Recent (within 2 years prior to enrollment) immigration to the United States or other country with low to moderate TB incidence, from a country with an estimated incidence rate of TB \> 150 per 100,000
  9. 7. An increased risk of TB due to medical conditions such as end-stage renal disease, or due to use of immunosuppressive medications such as chronic steroids or TNF-alpha inhibitors.
  10. * Willing to provide signed informed consent, or parental permission and participant assent.
  1. * Current confirmed culture-positive or clinical TB.
  2. * Suspected current TB. Includes cases in which active TB cannot be eliminated as a possibility (by the site investigator)
  3. * TB resistant to any rifamycin in the source case
  4. * A history of treatment for \> 7 consecutive days with a rifamycin or \> 30 consecutive days with INH within 2 years prior to enrollment.
  5. * A documented history of completing an adequate course of treatment for TB disease or LTBI in a person who is HIV-seronegative.
  6. * History of allergy or intolerance to rifamycins.
  7. * Serum alanine aminotransferase (ALT; SGPT) or serum aspartate aminotransferase (AST; SGOT) \> 5x upper limit of normal among persons in whom baseline ALT or AST is determined+.
  8. * HIV-seropositive and on antiretroviral therapy that cannot be given with rifampin or rifapentine due to drug-drug interactions.
  9. * Receiving concomitant medications that are known to be contraindicated with any study drug.
  10. * Females who are currently pregnant, breastfeeding, or intend to become pregnant within 120 days of enrollment.
  11. * Weight \< 25 kg.

Contacts and Locations

Study Contact

Rosanna M Boyd, PhD
CONTACT
+1 (404)-553-7434
icg7@cdc.gov
TBTC Research Administrator
CONTACT
+1 (800)-232-4636
tbtcresearchadmin@cdc.gov

Principal Investigator

Timothy Sterling, MD
STUDY_CHAIR
Vanderbilt University Medical Center, USA
Robert Belknap, MD
STUDY_CHAIR
Denver Public Health (USA)
Amber Robinson, PhD
STUDY_DIRECTOR
Centers for Disease Control and Prevention
Rosanna M Boyd, PhD
STUDY_DIRECTOR
Centers for Disease Control (USA)
Dick Menzies, MD
STUDY_CHAIR
McGill University

Study Locations (Sites)

Denver Health and Hospital Authority
Denver, Colorado, 80204
United States
George Washington University
Washington, District of Columbia, 20001
United States
Washington DC VA Medical Center
Washington, District of Columbia, 20001
United States
New York Harbor Healthcare System
Manhattan, New York, 10001
United States
New York City Bureau of TB Control
New York, New York, 11201
United States
San Antonio VA
San Antonio, Texas, 78201
United States
Seattle King County Health Department
Seattle, Washington, 98101
United States

Collaborators and Investigators

Sponsor: Centers for Disease Control and Prevention

  • Timothy Sterling, MD, STUDY_CHAIR, Vanderbilt University Medical Center, USA
  • Robert Belknap, MD, STUDY_CHAIR, Denver Public Health (USA)
  • Amber Robinson, PhD, STUDY_DIRECTOR, Centers for Disease Control and Prevention
  • Rosanna M Boyd, PhD, STUDY_DIRECTOR, Centers for Disease Control (USA)
  • Dick Menzies, MD, STUDY_CHAIR, McGill University

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2019-08-01
Study Completion Date2029-12

Study Record Updates

Study Start Date2019-08-01
Study Completion Date2029-12

Terms related to this study

Keywords Provided by Researchers

  • latent tuberculosis
  • rifapentine

Additional Relevant MeSH Terms

  • Latent Tuberculosis