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Shorter and Safer Treatment Regimens for Latent TB
Sponsor: McGill University Health Centre/Research Institute of the McGill University Health Centre
Summary
Our study rationale is based on: 1. Tuberculosis Preventive Treatment (TPT) is given to healthy people and needs to be safe; 2. Tuberculosis Preventive Treatment (TPT) with shorter regimens are superior with respect to acceptance, completion, and costs; 3. 4 months of Rifampin 10mg/kg (4R10) is the safest regimen, but is completed by \<80% of patients; 4. The safety of 2 months of Rifampin 20mg/kg (2R20) is similar to that of 4 months of Rifampin 10mg/kg (4R10), but completion is a concern; 5. 1-month regimens have promising efficacy; 6. Safety and tolerability must be carefully assessed with comparisons to 4 months of Rifampin 10mg/kg (4R10), and head-to-head with each other. OBJECTIVES: The investigator will use a Bayesian adaptive Phase 2 randomized open-label trial design to test at least three experimental Tuberculosis Preventive Treatment (TPT) regimens to identify at least one regimen of ≤2 months duration that has non-inferior safety, completion, and tolerability in adults and children relative to the reference Tuberculosis Preventive Treatment (TPT) regimen. The shortest, safest, and best tolerated regimen identified in this Phase 2 trial will be tested for effectiveness and efficacy in a Phase 3 trial. Specific Tuberculosis Preventive Treatment (TPT) regimens (All are daily and self-administered) Reference: Rifampin at a dose of 10 mg/kg/day for 4 months (4R10); Experimental: 1) Rifampin at 20 mg/kg/day for 2 months (2R20); (2) one month Levofloxacin and Rifapentine (1LP). At a later stage a 3rd experimental regimen will be selected and added: one another novel 1-2-month regimen identified from pre-clinical and clinical studies. When selected, this will be explained fully including preliminary data on safety and efficacy in an amended protocol and consent - which will be submitted for ethics and regulatory approval at that time).
Official title: SSTARLET: Shorter and Safer Treatment Regimens for Latent TB
Key Details
Gender
All
Age Range
5 Years - Any
Study Type
INTERVENTIONAL
Enrollment
1800
Start Date
2025-06-10
Completion Date
2029-06-01
Last Updated
2026-02-10
Healthy Volunteers
No
Conditions
Interventions
rifampin standard arm
120 doses daily self-administered rifampin at 10mg/kg/day (max 600mg/day)
rifampin double dose
60 doses daily self-administered rifampin at 20 mg/kg (max. 1200 mg/day)
levofloxacin and rifapentine
30 doses daily self-administered levofloxacin (15 mg/kg, max 750mg/day and rifapentine (10mg/kg, max: 600mg)
Locations (13)
Centre National Hospitalier Universitaire de Pneumo Phtisiologie de Cotonou (CNHU-PPC)
Cotonou, Benin
Manaus
Manaus, Brazil
Unviversity of Calgary
Calgary, Alberta, Canada
The Governors of the University of Alberta
Edmonton, Alberta, Canada
BCCDC TB clinic
Vancouver, British Columbia, Canada
University of Manitoba
Winnipeg, Manitoba, Canada
University of Ottawa
Ottawa, Ontario, Canada
St. Michael's Hospital
Toronto, Ontario, Canada
University Health Network
Toronto, Ontario, Canada
MUHC
Montreal, Quebec, Canada
Hopital du Sacré-Coeur de Montreal
Montreal, Quebec, Canada
Universitas Padjadjaran, Klinik Penelitian Tuberculosis (TB research clinic)
Bandung, Indonesia
Vietnam
Ho Chi Minh City, Vietnam