Pragmatic Optimized Rifampicin Trial

Launched by RADBOUD UNIVERSITY MEDICAL CENTER · Sep 26, 2023

Keywords

ClinConnect Summary

The Pragmatic Optimized Rifampicin Trial is a study designed to find out if a higher dose of rifampicin (1800 mg daily) is safer and more effective than the standard doses (450 mg for patients under 50 kg and 600 mg for those over 50 kg) for treating pulmonary tuberculosis. The researchers want to see if the higher dose causes more liver problems, if patients experience more side effects, and how well each dose helps patients recover from tuberculosis. They will also look at how quickly the bacteria in patients' bodies are eliminated with both dosing methods.

To participate in this trial, you must be at least 18 years old, have a diagnosis of pulmonary tuberculosis, and have not had any serious allergic reactions to rifampicin before. Women who can become pregnant must use effective birth control during the study. If you join, you will take the higher dose of rifampicin daily, and your health will be monitored closely. This trial is currently recruiting participants, so if you or someone you know is interested, it's a good opportunity to contribute to important research in tuberculosis treatment.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • The patient has provided informed consent for study participation prior to all trial-related procedures.
• • The patient has a diagnosis of pulmonary tuberculosis according to the local diagnostic criteria.
• • The patient is aged 18 years or older at the day of informed consent.
• • No known allergic reactions or toxicity to rifampicin in the past.
• • Female patients of childbearing potential must have a negative serum pregnancy test, and consent to practice an effective method of birth control during the study. And they should not be lactating during the trial (female participants of childbearing potential only). Effective birth control for female patients has to include two methods, including methods that the patient's sexual partner(s) use. At least one must be a barrier method. Female patients are considered not to be of childbearing potential if they are post-menopausal with no menses for the last 12 months, or surgically sterile (this condition is fulfilled by bilateral oophorectomy, hysterectomy, and by tubal ligation which is done at least 12 months prior to enrolment).
• • The patient will be compliant to the study schedule, in the discretion of the investigator.
• Exclusion Criteria:
• • The patient has tuberculosis which is assessed to receive high dose rifampicin according to the local standard of care.
• • The patient started current TB treatment more than 4 weeks ago.
• • The patient has TB meningitis.
• • The patient is in a coma.
• • Circumstances that raise doubt about free, uncoerced consent to study participation (e.g. in a prisoner or mentally handicapped person)
• • The patient is not able to give consent personally.
• • Poor general condition or comorbidities where delay in treatment cannot be tolerated or death within three months is likely. Or if there is concurrent treatment that may interfere.
• • The patient is pregnant or breast-feeding.
• • Patient infected with a rifampicin-resistant strain of M. tuberculosis.
• • Known allergy or intolerance for rifamycins.
• • The participant has a known or suspected, current alcohol or drug or amphetamine abuse, that is, in the opinion of the investigator, sufficient to compromise the safety or cooperation of the patient.
• • The patient has a known allergy or intolerance, or concomitant disorders or conditions for which rifamycins or other standard TB treatment drugs are contraindicated.
• • The patient has had treatment with any other investigational drug within 1 month prior to enrolment, or enrolment into other clinical (intervention) trials is planned in the upcoming 6 months
• * Laboratory: at screening one or more of the following abnormalities were observed for the patient in screening laboratory:
• • Serum amino aspartate transferase (AST) and/or serum alanine aminotransferase (ALT) activity \>3x the upper limit of normal
• • Serum total bilirubin level \>2.5 times the upper limit of normal
• • Creatinine clearance (CrCl) level lower than 30 mls/min
• • Acute or severe or life-threatening liver disease induced by drugs in the past
• • The patient has a chronic disorder such as liver disease or renal disease.
• • The patient has icterus.
• • Previous anti-TB treatment: the patient ended a previous TB treatment (episode) within last 3 months.