About this trial
A5409/RAD-TB is an adaptive Phase 2 randomized, controlled, open-label, dose-ranging, platform protocol to evaluate the safety and efficacy of multidrug regimens for the treatment of adults with drug-susceptible pulmonary tuberculosis (TB).
A5409 hypothesizes that novel regimens for the treatment of pulmonary tuberculosis will result in superior early efficacy, as determined by longitudinal mycobacteria growth indicator tube (MGIT) liquid culture time to positivity (TTP) measurements over the first 6 weeks of treatment, and will have acceptable safety and tolerability over 8 weeks of treatment relative to standard of care \[(SOC) isoniazid/rifampicin/pyrazinamide/ethambutol (HRZE)\].
The study will run for 52 weeks, inclusive of 26 weeks of TB treatment comprised of 8 weeks of study treatment (experimental or SOC, based on treatment arm assignment) followed by 18 weeks of SOC continuation phase treatment with 45 participants in each experimental treatment arm and at least 90 participants in the SOC arm.
Eligibility criteria
Qualifiers
Pulmonary TB (among individuals either without history of prior TB treatment or with history of TB treatment completed more than 2 years prior to study entry), identified within 7 days prior to study entry by at least one sputum specimen positive for Mtb by Xpert. Semiquantitative Mtb results of "medium" or "high" from Xpert MTB/RIF Ultra are required.
Pulmonary TB with documented INH susceptibility (by Line Probe Assay (LPA) or Xpert MTB/XDR or other validated molecular test) and with documented RIF susceptibility (by LPA or Xpert MTB/RIF or Xpert MTB/RIF Ultra or other validated molecular test) within 7 days prior to study entry.
A second antibody test from different manufacturers or based on different principles and epitopes (combination antigen-antibody-based rapid tests may be used), or
HIV-1 antigen, or
Disqualifiers
More than cumulative 7 days of treatment directed against active TB for the current TB episode in the 60 days preceding study entry.
Current extrapulmonary TB, in the opinion of the investigator.
QTcF interval >450 ms within 7 days prior to study entry.
History of or ongoing heart failure.
Trial design
Treatments tested in this trial
- Isoniazid
- Rifampicin
- Pyrazinamide
- Ethambutol
- Bedaquiline
- Pretomanid
- Linezolid
- TBI-223
- Sutezolid
- TBI-223
- Sutezolid
Treatment groups
6
Treatment groupsSee each treatment group below.
Sponsors and collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
Lead sponsor
TB Alliance
Collaborator