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NCT01404312

Brief Rifapentine-Isoniazid Evaluation for TB Prevention (BRIEF TB)

Completed Phase 3 Results posted Last updated 4 November 2021
What this trial tests

Phase 3 trial testing Rifapentine (RPT) in Tuberculosis in 3,000 participants. Completed in 14 November 2017.

Timeline
23 May 2012
Primary endpoint
14 November 2017
14 November 2017

Quick facts

Lead sponsorNational Institute of Allergy and Infectious Diseases (NIAID)
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposeprevention
Enrollment3,000
Start date23 May 2012
Primary completion14 November 2017
Estimated completion14 November 2017
Sites45 locations across Zimbabwe, Haiti, South Africa, Peru, Malawi, Botswana, Thailand, Kenya

Drugs / interventions tested

Conditions studied

Sponsor

National Institute of Allergy and Infectious Diseases (NIAID)

Who can join

13 and older, any sex, with Tuberculosis or HIV Infections. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Incidence of First Diagnosis of Active Tuberculosis, Death Related to Tuberculosis, or Death From Unknown Cause Primary · From entry to occurrence of event, up to end of follow-up 3 years after last participant enrolled (median follow-up time: 3.3 years)

Incidence rate (events per 100 person-years) was estimated, and 95.1% confidence interval used to account for interim analysis of primary efficacy outcome.

GroupValue95% CI
RPT Plus INH Regimen (Arm A)0.65060.4242 – 0.8770
INH Regimen (Arm B)0.67360.4428 – 0.9045
Number of Participants With Occurrence of One or More Serious Adverse Events (SAEs) Versus no SAEs Secondary · From entry to occurrence of event, up to end of follow-up 3 years after last participant enrolled (median follow-up time: 3.3 years)

Occurrence of any SAE that meets the ICH definition of an SAE

GroupValue95% CI
RPT Plus INH Regimen (Arm A)1405
INH Regimen (Arm B)1390
RPT Plus INH Regimen (Arm A)83
INH Regimen (Arm B)108
Number of Participants With a Targeted Adverse Event Secondary · From entry to occurrence of event, up to end of follow-up 3 years after last participant enrolled (median follow-up time: 3.3 years)

Targeted adverse events include each new grade 3 or 4 laboratory value or sign or symptom that is at least one grade increase from baseline for the following: nausea and vomiting; cutaneous; drug-associated fever; elevated aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\]), alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase \[SGPT\]), or bilirubin; and peripheral neuropathy

GroupValue95% CI
RPT Plus INH Regimen (Arm A)1445
INH Regimen (Arm B)1446
RPT Plus INH Regimen (Arm A)43
INH Regimen (Arm B)52
Number of Participants in Each Category of Ordered Categorical Variable Indicating Most Stringent Level of Study Drug Management Due to Toxicity That Was Required Over the Treatment Period Secondary · From entry to end of treatment (up to 8 weeks for Arm A; up to 54 weeks for Arm B)

Ordered categories include: 1. Premature permanent treatment discontinuation 2. Treatment hold for more than 7 consecutive days 3. None of the above

GroupValue95% CI
RPT Plus INH Regimen (Arm A)16
INH Regimen (Arm B)25
RPT Plus INH Regimen (Arm A)11
INH Regimen (Arm B)31
RPT Plus INH Regimen (Arm A)1461
INH Regimen (Arm B)1442
Cumulative Incidence of Death From Any Cause Secondary · From entry to occurrence of event, up to end of follow-up 3 years after last participant enrolled (median follow-up time: 3.3 years)

Data table estimates for percentage who died by each time point were estimated using Kaplan-Meier at 1, 2, 3, and 4 years post-entry.

1 year post-entry
GroupValue95% CI
RPT Plus INH Regimen (Arm A)0.35
INH Regimen (Arm B)0.63
2 years post-entry
GroupValue95% CI
RPT Plus INH Regimen (Arm A)0.49
INH Regimen (Arm B)1.15
3 years post-entry
GroupValue95% CI
RPT Plus INH Regimen (Arm A)1.05
INH Regimen (Arm B)1.62
4 years post-entry
GroupValue95% CI
RPT Plus INH Regimen (Arm A)2.00
INH Regimen (Arm B)2.29
Cumulative Incidence of Death Due to a Non-TB Event Secondary · From entry to occurrence of event, up to end of follow-up 3 years after last participant enrolled (median follow-up time: 3.3 years)

Cumulative incidence function estimated nonparametrically, treating TB-related deaths as competing risks.

Cumulative incidence by 1 year post-randomization
GroupValue95% CI
RPT Plus INH Regimen (Arm A)0.3
INH Regimen (Arm B)0.5
Cumulative incidence by 2 years post-randomization
GroupValue95% CI
RPT Plus INH Regimen (Arm A)0.4
INH Regimen (Arm B)1.0
Cumulative incidence by 3 years post-randomization
GroupValue95% CI
RPT Plus INH Regimen (Arm A)0.9
INH Regimen (Arm B)1.5
Cumulative incidence by 4 years post-randomization
GroupValue95% CI
RPT Plus INH Regimen (Arm A)1.6
INH Regimen (Arm B)2.0
Number of Participants With Antibiotic Resistance Among Mycobacterium Tuberculosis (MTB) Isolates in Participants Who Develop Active Tuberculosis Secondary · After TB diagnosis

Among MTB-diagnosed participants who underwent drug-susceptibility testing, the number who had any resistance to a particular drug.

Rifampin
GroupValue95% CI
RPT Plus INH Regimen (Arm A)1
INH Regimen (Arm B)1
RPT Plus INH Regimen (Arm A)14
INH Regimen (Arm B)11
Isoniazid
GroupValue95% CI
RPT Plus INH Regimen (Arm A)2
INH Regimen (Arm B)1
RPT Plus INH Regimen (Arm A)12
INH Regimen (Arm B)11
Ethambutol
GroupValue95% CI
RPT Plus INH Regimen (Arm A)0
INH Regimen (Arm B)1
RPT Plus INH Regimen (Arm A)7
INH Regimen (Arm B)7
Pyrazinamide
GroupValue95% CI
RPT Plus INH Regimen (Arm A)0
INH Regimen (Arm B)0
RPT Plus INH Regimen (Arm A)6
INH Regimen (Arm B)6
Efavirenz (EFV) Plasma Concentrations in Arm A Secondary · Measured at Weeks 0, 2, 4, and 16

Mean and standard deviation. Week 16 samples have not yet been analyzed because the metabolite assay is being validated, and requires submission for approval by the Clinical Pharmacology Quality Assurance Program. Analysis of week 16 samples are anticipated to be available in September 2019.

Week 0
GroupValue95% CI
RPT Plus INH Regimen (Arm A)3787± 4922
Week 2
GroupValue95% CI
RPT Plus INH Regimen (Arm A)3870± 7011
Week 4
GroupValue95% CI
RPT Plus INH Regimen (Arm A)4082± 4916
Nevirapine (NVP) Plasma Concentrations in Arm A Secondary · Measured at Weeks 0, 2, and 4

Mean and standard deviation

Week0
GroupValue95% CI
RPT Plus INH Regimen (Arm A)7573± 3789
Week 2
GroupValue95% CI
RPT Plus INH Regimen (Arm A)6234± 4283
Week 4
GroupValue95% CI
RPT Plus INH Regimen (Arm A)5797± 3963

Adverse events — posted to ClinicalTrials.gov

Time frame: From entry to end of follow-up 3 years after last participant enrolled (median follow-up time: 3.3 years). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

RPT Plus INH Regimen (Arm A)
Serious: 40/1496 (3%)
Deaths: 21/1496
INH Regimen (Arm B)
Serious: 68/1504 (5%)
Deaths: 27/1504

Serious adverse events (77 terms)

ReactionSystemRPT Plus INH Regimen (Arm A)INH Regimen (Arm B)
Hepatic enzyme increasedInvestigations
NeutropeniaBlood and lymphatic system disorders
SeizureNervous system disorders
AnaemiaBlood and lymphatic system disorders
Intestinal obstructionGastrointestinal disorders
DeathGeneral disorders
Drug-induced liver injuryHepatobiliary disorders
HepatotoxicityHepatobiliary disorders
Disseminated tuberculosisInfections and infestations
PneumoniaInfections and infestations
Transaminases increasedInvestigations
DehydrationMetabolism and nutrition disorders
Hepatocellular carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Abortion incompletePregnancy, puerperium and perinatal conditions
Suicide attemptPsychiatric disorders
RashSkin and subcutaneous tissue disorders
ThrombocytopeniaBlood and lymphatic system disorders
Bundle branch block rightCardiac disorders
Abdominal painGastrointestinal disorders
Anal fistulaGastrointestinal disorders
AscitesGastrointestinal disorders
HaematemesisGastrointestinal disorders
Inguinal herniaGastrointestinal disorders
Umbilical hernia, obstructiveGastrointestinal disorders
VomitingGastrointestinal disorders
Other adverse events (24 terms — click to expand)

ReactionSystemRPT Plus INH Regimen (Arm A)INH Regimen (Arm B)
CoughRespiratory, thoracic and mediastinal disorders
Blood sodium decreasedInvestigations
Oropharyngeal painRespiratory, thoracic and mediastinal disorders
PyrexiaGeneral disorders
Neutrophil count decreasedInvestigations
HeadacheNervous system disorders
RhinorrhoeaRespiratory, thoracic and mediastinal disorders
Blood albumin decreasedInvestigations
Nasal congestionRespiratory, thoracic and mediastinal disorders
Alanine aminotransferase increasedInvestigations
Haemoglobin decreasedInvestigations
Upper respiratory tract infectionInfections and infestations
Aspartate aminotransferase increasedInvestigations
DiarrhoeaGastrointestinal disorders
Blood sodium increasedInvestigations
Weight decreasedInvestigations
PregnancyPregnancy, puerperium and perinatal conditions
Blood alkaline phosphatase increasedInvestigations
HypertensionVascular disorders
NasopharyngitisInfections and infestations
PharyngitisInfections and infestations
Abdominal painGastrointestinal disorders
Blood pressure increasedInvestigations
TonsillitisInfections and infestations

Most-reported serious reactions: Hepatic enzyme increased, Neutropenia, Seizure, Anaemia, Intestinal obstruction, Death, Drug-induced liver injury, Hepatotoxicity.

Data from ClinicalTrials.gov NCT01404312 adverse events section.

Sponsor's own description

HIV-infected people have an increased risk of developing active tuberculosis (TB). At the time the study was designed, the standard course of treatment for TB was 6 to 9 months of isoniazid (INH).This study compared the safety and effectiveness of a 4-week regimen of rifapentine (RPT) plus INH versus a standard 9-month regimen of INH in HIV-infected people who are at risk of developing active TB.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. One Month of Rifapentine plus Isoniazid to Prevent HIV-Related Tuberculosis.
    Swindells S, Ramchandani R, Gupta A, Benson CA, et al · · 2019 · cited 247× · PMID 30865794 · DOI 10.1056/nejmoa1806808
  2. Inclusion of key populations in clinical trials of new antituberculosis treatments: Current barriers and recommendations for pregnant and lactating women, children, and HIV-infected persons.
    Gupta A, Hughes MD, Garcia-Prats AJ, McIntire K, et al · · 2019 · cited 34× · PMID 31415563 · DOI 10.1371/journal.pmed.1002882
  3. Moving toward Tuberculosis Elimination. Critical Issues for Research in Diagnostics and Therapeutics for Tuberculosis Infection.
    Keshavjee S, Amanullah F, Cattamanchi A, Chaisson R, et al · · 2019 · cited 21× · PMID 30335466 · DOI 10.1164/rccm.201806-1053pp
  4. TB and HIV Therapeutics: Pharmacology Research Priorities.
    Dooley KE, Kim PS, Williams SD, Hafner R. · · 2012 · cited 14× · PMID 22829999 · DOI 10.1155/2012/874083
  5. Pharmacogenetic interactions of rifapentine plus isoniazid with efavirenz or nevirapine.
    Haas DW, Podany AT, Bao Y, Swindells S, et al · · 2021 · cited 12× · PMID 32815870 · DOI 10.1097/fpc.0000000000000417
  6. One size does not fit all: community views on choices for TB treatment and prevention.
    Makone A, Angami K, Bhattacharya D, Frick M, et al · · 2023 · cited 9× · PMID 37736579 · DOI 10.5588/pha.23.0034
  7. 2019: A Banner Year for Tuberculosis Research.
    Eisinger RW, Embry AC, Read SW, Fauci AS. · · 2020 · cited 6× · PMID 32043109 · DOI 10.1093/infdis/jiaa051
  8. Applying a Risk-benefit Analysis to Outcomes in Tuberculosis Clinical Trials.
    Miyahara S, Ramchandani R, Kim S, Evans SR, et al · · 2020 · cited 5× · PMID 31414121 · DOI 10.1093/cid/ciz784

Verify or expand the search:

Other trials of Rifapentine (RPT)

Trials testing the same drug.

Other recruiting trials for Tuberculosis

Currently open trials in the same condition.

Other National Institute of Allergy and Infectious Diseases (NIAID) trials

Trials by the same sponsor.

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