Platform Assessing Regimens and Durations In a Global Multisite Consortium for TB
Summary
The UNITE4TB consortium is a group of universities and pharmaceutical companies funded by the European Union. This consortium are carrying out a trial to find better and faster ways to treat tuberculosis (TB). The standard treatment for TB takes 24 weeks and uses four drugs. The consortium want to find new treatments that are faster but just as safe and effective. In the trial, two new drugs will be used, BTZ-043 and GSK3036656, along with the drugs that are already used to treat TB in a variety of combinations (11 different combinations initially). These new drugs have worked well in tests with animals and have reduced the amount of TB bacteria in people's sputum/phlegm when used alone for two weeks. These new drugs will be used in combination with other TB drugs for a longer time (up to 16 weeks) in people with TB. The UNITE4TB consortium want to see if they work well and are safe. This trial will take place at sites across the world and will involve people with TB of the lungs that would usually respond well to the standard treatment. But the new treatments being tested might also work for people with drug resistant TB, that's harder to treat. The trial has two parts. In the first part, different combinations of drugs will be tried on up to 700 people for 16 weeks. These combinations will be compared to the standard 24-week treatment to see which ones work the best and are safe. In the second part, the best combinations from the first part will be taken to try to find out what the best length of time is to give the treatment for. These combinations will be tried on up to 1800 people giving them either 8, 10, 12, 14 or 16 weeks treatment. The investigators will follow these people for a total of 72 weeks to make sure the treatment is working. The UNITE4TB consortium hope that this trial will find new treatments that are fast, safe, and effective for both regular TB and resistant TB. If it works, it can then be tested again in a bigger trial to be sure.
Timeline
- Start
- 2024-01-09
- Primary completion
- 2027-02-24
- Completion
- 2027-08-11
Publications
- Background Eckhardt E, Li Y, Mamerow S, Schinkothe J, Sehl-Ewert J, Dreisbach J, Corleis B, Dorhoi A, Teifke J, Menge C, Kloss F, Bastian M. Pharmacokinetics and Efficacy of the Benzothiazinone BTZ-043 against Tuberculous Mycobacteria inside Granulomas in the Guinea Pig Model. Antimicrob Agents Chemother. 2023 Apr 18;67(4):e0143822. doi: 10.1128/aac.01438-22. Epub 2023 Mar 28.
- Background Tenero D, Derimanov G, Carlton A, Tonkyn J, Davies M, Cozens S, Gresham S, Gaudion A, Puri A, Muliaditan M, Rullas-Trincado J, Mendoza-Losana A, Skingsley A, Barros-Aguirre D. First-Time-in-Human Study and Prediction of Early Bactericidal Activity for GSK3036656, a Potent Leucyl-tRNA Synthetase Inhibitor for Tuberculosis Treatment. Antimicrob Agents Chemother. 2019 Jul 25;63(8):e00240-19. doi: 10.1128/AAC.00240-19. Print 2019 Aug.
- Background Li X, Hernandez V, Rock FL, Choi W, Mak YSL, Mohan M, Mao W, Zhou Y, Easom EE, Plattner JJ, Zou W, Perez-Herran E, Giordano I, Mendoza-Losana A, Alemparte C, Rullas J, Angulo-Barturen I, Crouch S, Ortega F, Barros D, Alley MRK. Discovery of a Potent and Specific M. tuberculosis Leucyl-tRNA Synthetase Inhibitor: (S)-3-(Aminomethyl)-4-chloro-7-(2-hydroxyethoxy)benzo[c][1,2]oxaborol-1(3H)-ol (GSK656). J Med Chem. 2017 Oct 12;60(19):8011-8026. doi: 10.1021/acs.jmedchem.7b00631. Epub 2017 Sep 27.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | BTZ-043 | Small molecule | 1000 mg | Oral |
| Subject | Bedaquiline | Small molecule | 100 mg | Oral |
| Subject | Delamanid | Small molecule | 300 mg | Oral |
| Subject | Delpazolid | Small molecule | 1200 mg | Oral |
| Comparator | Ethambutol | Small molecule | 825 mg | Oral |
| Comparator | Ethambutol | Small molecule | 1375 mg | Oral |
| Subject | Ganfeborole | Small molecule | 20 mg | Oral |
| Comparator | Isoniazid | Small molecule | 225 mg | Oral |
| Comparator | Isoniazid | Small molecule | 375 mg | Oral |
| Subject | Linezolid | Other / unclassified | 600 mg | Oral |
| Subject | Moxifloxacin | Small molecule | 400 mg | Oral |
| Subject | Pretomanid | Small molecule | 200 mg | Oral |
| Subject | Pyrazinamide | Small molecule | 1200 mg | Oral |
| Subject | Pyrazinamide | Small molecule | 2000 mg | Oral |
| Subject | Quabodepistat | Small molecule | 30 mg | Oral |
| Comparator | Rifampin | Small molecule | 450 mg | Oral |
| Comparator | Rifampin | Small molecule | 750 mg | Oral |