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Evaluation of the Pharmacokinetics of Antituberculosis Drugs and Tuberculosis Treatment Outcomes (SOUTH)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified April 2015 by Infectious Diseases Institute, Makerere University.
Recruitment status was:  Recruiting
ClinicalTrials.gov Identifier:
First Posted: February 4, 2013
Last Update Posted: April 13, 2015
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Infectious Diseases Institute, Makerere University
Tuberculosis (TB) is a leading cause of death in HIV-infected individuals. There are insufficient data correlating concentrations of anti-TB drugs with treatment response. We hypothesize that sub-therapeutic concentrations of anti-TB drugs are associated with inadequate TB treatment response to Mycobacterium tuberculosis.

Condition Intervention Phase
AIDS With Tuberculosis Drug: Rifampicin, Isoniazid, Ethambutol, Pyrazinamide Phase 4

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Evaluation of the Pharmacokinetics of Antituberculosis Drugs and Tuberculosis Treatment Outcomes in HIV-tuberculosis Co-infected Ugandan Adults

Resource links provided by NLM:

Further study details as provided by Infectious Diseases Institute, Makerere University:

Primary Outcome Measures:
  • clinical outcome [ Time Frame: At the end of treatment (6 months after enrolmet) ]
    To investigate the association between serum concentrations of antituberculosis drugs and tuberculosis treatment response in HIV-TB-co-infected individuals.

Secondary Outcome Measures:
  • Cmax [ Time Frame: At 2 weeks, 8 weeks and 24 weeks after anti-tuberculosis drug initiation ]
    To investigate the steady-state pharmacokinetic parameters of anti-TB drugs at different time-points over the course of TB-treatment

  • Number of adverse events [ Time Frame: 2 weeks, 8 weeks and 24 weeks after anti-tuberculosis drug initiation ]
    To assess the safety and tolerability of anti-TB drugs based on the WHO guidelines

  • ART trough levels [ Time Frame: At 2 weeks, 8 weeks and 24 weeks after anti-tuberculosis drug initiation ]
    To correlate the effect of anti-TB drugs on plasma concentrations of efavirenz or protease inhibitors and vice versa.

  • Isoniazid Cmax [ Time Frame: At 2 weeks, 8 weeks and 24 weeks ]
    To evaluate the effect of acetylator geno-and phenotype (NAT-2 gene) on isoniazid plasma concentrations and toxicity

Estimated Enrollment: 400
Study Start Date: February 2013
Estimated Study Completion Date: March 2016
Estimated Primary Completion Date: March 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
anti-tuberculosis drugs
Rifampicin, Isoniazid, Ethambutol, Pyrazinamide tablets 3 to 5 tablets once daily for 2 months followed by Rifampicin, Isoniazid 3 to 5 tablets once daily for 4 months
Drug: Rifampicin, Isoniazid, Ethambutol, Pyrazinamide
Rifampicin, Isoniazid, Ethambutol, Pyrazinamide: 3, 4 or 5 tablets daily for weight below 55kg, above 55kg or above 70kg respectively for first 2 months followed by Rifampicin, Isoniazid: 3, 4 or 5 tablets daily for patients' weight below 55kg, above 55kg or above 70kg respectively for 4 months
Other Names:
  • Forecox Trac
  • and Montozid

Detailed Description:

During the study periodic monitoring will be conducted to ensure that the protocol and Good Clinical Practices (GCPs) are being followed.The monitors may review source documents to confirm that the data recorded on CRFs is accurate. The study site may be subject to review by the Institutional Review Board (IRB) and/or appropriate regulatory authorities.

A CRF will be completed for each included subject and will be signed by the investigator or by an authorized staff member to attest that the data is true. Any corrections to entries made in the CRFs, source documents must be dated, initialed and explained (if necessary) and should not obscure the original entry. Qualit assurance will as also be performed regularly on the CRFs.

The primary end point will be analyzed using Time to event (cure, death, relapse etc)analysis and failure rates and hazard ratios will be calculated accordig to categorical drug concentrations with proposed cutt offs.

Secondary end points will be analysed using time to event for occurence of toxicities which will also be corelated to the drug concentrations.


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Evidence of a personally signed and dated informed consent
  • Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
  • Age of ≥18 years
  • First episode of pulmonary TB i.e. proven or highly suspected TB considered for TB treatment qualifying for 6 months anti-Tb drugs regimen
  • Confirmed HIV-1 infection

Exclusion Criteria:

  • Unable to provide informed consent
  • Documented or highly suspected TB infection of any organs/systems other than the lung requiring TB treatment longer than 6 months
  • Previously treated for a mycobacterial infection (TB or atypical mycobacterial infection, active or latent)
  • Pregnancy or planned pregnancy within the next year
  • Unwillingness to perform pregnancy test
  • Decompensated liver disease and/or aminotransferases >5x ULN
  • GFR < 50 ml/min
  • Co-morbidities reducing life expectancy to <1 year (e.g. cancer)
  • Patient wishes to take part in another interventional study
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01782950

Contact: Andrew Kambugu, MMED +256-414-307000 ext 227 akambugu@idi.co.ug

Infectious Diseases Institute Recruiting
Kampala, Uganda, 256
Contact: Christine Sekaggya, MMed    +256312307000 ext 370    csekaggya@idi.co.ug   
Principal Investigator: Barbara Castelnuovo, MBChB, PhD         
Sponsors and Collaborators
Makerere University
Principal Investigator: Barbara Castelnuovo, MD, PhD Infectious Diseases Institute
  More Information

Chideya S, Winston CA, Peloquin CA, Bradford WZ, Hopewell PC, Wells CD, Reingold AL, Kenyon TA, Moeti TL, Tappero JW. Isoniazid, rifampin, ethambutol, and pyrazinamide pharmacokinetics and treatment outcomes among a predominantly HIV-infected cohort of adults with tuberculosis from Botswana. Clin Infect Dis. 2009 Jun 15;48(12):1685-94. doi: 10.1086/599040.
Weiner M, Benator D, Burman W, Peloquin CA, Khan A, Vernon A, Jones B, Silva-Trigo C, Zhao Z, Hodge T; Tuberculosis Trials Consortium. Association between acquired rifamycin resistance and the pharmacokinetics of rifabutin and isoniazid among patients with HIV and tuberculosis. Clin Infect Dis. 2005 May 15;40(10):1481-91. Epub 2005 Apr 14.
Gurumurthy P, Ramachandran G, Hemanth Kumar AK, Rajasekaran S, Padmapriyadarsini C, Swaminathan S, Bhagavathy S, Venkatesan P, Sekar L, Mahilmaran A, Ravichandran N, Paramesh P. Decreased bioavailability of rifampin and other antituberculosis drugs in patients with advanced human immunodeficiency virus disease. Antimicrob Agents Chemother. 2004 Nov;48(11):4473-5.
Narita M, Hisada M, Thimmappa B, Stambaugh J, Ibrahim E, Hollender E, Ashkin D. Tuberculosis recurrence: multivariate analysis of serum levels of tuberculosis drugs, human immunodeficiency virus status, and other risk factors. Clin Infect Dis. 2001 Feb 1;32(3):515-7. Epub 2001 Jan 25.
Gumbo T, Louie A, Deziel MR, Liu W, Parsons LM, Salfinger M, Drusano GL. Concentration-dependent Mycobacterium tuberculosis killing and prevention of resistance by rifampin. Antimicrob Agents Chemother. 2007 Nov;51(11):3781-8. Epub 2007 Aug 27.

Responsible Party: Infectious Diseases Institute, Principal Investigator, Makerere University
ClinicalTrials.gov Identifier: NCT01782950     History of Changes
Other Study ID Numbers: IDI
First Submitted: January 9, 2013
First Posted: February 4, 2013
Last Update Posted: April 13, 2015
Last Verified: April 2015

Keywords provided by Infectious Diseases Institute, Makerere University:
Antituberculosis drugs

Additional relevant MeSH terms:
Mycobacterium Infections
Actinomycetales Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Antitubercular Agents
Antibiotics, Antitubercular
Anti-Bacterial Agents
Anti-Infective Agents
Leprostatic Agents
Nucleic Acid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Cytochrome P-450 CYP2B6 Inducers
Cytochrome P-450 Enzyme Inducers
Cytochrome P-450 CYP2C8 Inducers
Cytochrome P-450 CYP2C19 Inducers
Cytochrome P-450 CYP2C9 Inducers
Cytochrome P-450 CYP3A Inducers
Fatty Acid Synthesis Inhibitors
Hypolipidemic Agents
Lipid Regulating Agents

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