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Phase 2 N=122 Randomized Treatment

A Phase 1/2 Trial of Multiple Oral Doses of OPC-167832 for Uncomplicated Pulmonary Tuberculosis

Pulmonary TB

Enrolled (actual)
122
Serious AEs
2.5%
Results posted
Nov 2023
Primary outcome: Primary: Stage 1: Change From Baseline in TB Bacterial Load in Sputum as a Measure of Early Bactericidal Activity (EBA) — -1.93; -2.12; -2.08; -1.69 sputum log10CFU/mL

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
10 mg OPC-167832 (Drug); 30 mg OPC-167832 (Drug); 90 mg OPC-167832 (Drug); 3 mg OPC-167832 (Drug); RHEZ (Drug); 30 mg OPC-167832 + 300 mg delamanid (Drug); 30 mg OPC-167832 + 400 mg BDQ (Drug); 30 mg OPC-167832 + 300 mg delamanid + 400 mg BDQ (Drug)
Age
Adult · 18+ yrs
Sex
All
Sponsor
Otsuka Pharmaceutical Development & Commercialization, Inc.
Primary completion
Feb 2022

Outcome Measures

OutcomeResultp-value
PRIMARY
Stage 1: Change From Baseline in TB Bacterial Load in Sputum as a Measure of Early Bactericidal Activity (EBA)
-1.93; -2.12; -2.08; -1.69; -2.79
PRIMARY
Stage 1 and Stage 2: Maximum (Peak) Plasma Concentration (Cmax) of OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
20.7; 53.7; 128; 391; 157; 154
PRIMARY
Stage 1 and Stage 2: Cmax at Steady-state (Cmax,ss) of OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
28.2; 67.3; 190; 492; 208; 175
PRIMARY
Stage 1 and Stage 2: Time to Cmax (Tmax) of OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
3.17; 4.15; 3.15; 3.25; 2.83; 3.17
PRIMARY
Stage 1 and Stage 2: Tmax of OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
3.17; 3.15; 3.13; 3.17; 2.83; 3.13
PRIMARY
Stage 1 and Stage 2: Area Under the Concentration-Time Curve (AUC) From Time Zero to Time t (the Last Observable Concentration, Here t=24) (AUC0-24), for OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
178; 569; 1290; 4050; 1450; 1490
PRIMARY
Stage 1 and Stage 2: AUC Calculated Over the Dosing Interval at Steady-state (AUCτ) for OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
349; 874; 2490; 5690; 2500; 2020
PRIMARY
Stage 1 and Stage 2: Terminal-phase Elimination Half-life (t1/2,z) of OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
22.3; 15.3; 14.2; 14.4; 14.4; 14.7
PRIMARY
Stage 1 and Stage 2: Apparent Clearance From Plasma at Steady-state (CLss/F) of OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
164; 195; 231; 272; 215; 269
PRIMARY
Stage 1 and Stage 2: Accumulation Ratio of Cmax (RCmax) for OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
1.39; 1.26; 1.56; 1.36; 1.34; 1.23
PRIMARY
Stage 1 and Stage 2: Accumulation Ratio of AUC (RAUC) for OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
1.99; 1.60; 2.01; 1.55; 1.70; 1.47
PRIMARY
Stage 1 and Stage 2: Cmax Normalized to Dose (Cmax/Dose) of OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
9.42; 6.73; 6.34; 5.46; 6.94; 5.85
PRIMARY
Stage 2: AUCτ Normalized to Dose (AUCτ/Dose) of OPC-167832 When Administered Alone (Stage 1) and in Combination With Delamanid, and BDQ (Stage 2)
116; 87.4; 82.8; 63.3; 83.5; 67.2
PRIMARY
Stage 2: Cmax of Delamanid
181; 198
PRIMARY
Stage 2: Cmax,ss of Delamanid
401; 442
PRIMARY
Stage 2: Tmax of Delamanid
3.83; 3.83
PRIMARY
Stage 2: Tmax of Delamanid
3.83; 3.83
PRIMARY
Stage 2: AUC0-24 of Delamanid
2140; 2440
PRIMARY
Stage 2: AUCτ of Delamanid
5460; 5860
PRIMARY
Stage 2: T1/2,z of Delamanid
25.4; 25.1
PRIMARY
Stage 2: CLss/F of Delamanid From Plasma
983; 966
PRIMARY
Stage 2: RCmax of Delamanid
2.26; 2.19
PRIMARY
Stage 2: RAUC of Delamanid
2.69; 2.49
PRIMARY
Stage 2: Cmax/Dose of Delamanid
1.34; 1.47
PRIMARY
Stage 2: AUCτ/Dose of Delamanid
18.2; 19.5
PRIMARY
Stage 2: Cmax of Bedaquiline
5150; 5750
PRIMARY
Stage 2: Cmax,ss of Bedaquiline
5030; 6080
PRIMARY
Stage 2: Tmax of Bedaquiline
5.17; 4.85
PRIMARY
Stage 2: Tmax of Bedaquiline
5.17; 4.85
PRIMARY
Stage 2: AUC0-24 of Bedaquiline
44900; 47000
PRIMARY
Stage 2: AUCτ of Bedaquiline
55900; 66000
PRIMARY
Stage 2: T1/2,z of Bedaquiline
NA; 81.1
PRIMARY
Stage 2: CLss/F of BDQ From Plasma
140; 109
PRIMARY
Stage 2: Cmax/Dose of Bedaquiline
12.6; 15.2
PRIMARY
Stage 2: AUCτ/Dose of Bedaquiline
140; 165
PRIMARY
Stage 1 and Stage 2: Number of Participants With Treatment-emergent Adverse Events (AEs)
10; 13; 13; 11; 15; 9
PRIMARY
Stage 1 and Stage 2: Number of Participants With Clinically Significant Changes in Vital Sign Values
1; 1; 0; 1; 1; 0
PRIMARY
Stage 1 and Stage 2: Number of Participants With Clinically Significant Changes in Electrocardiogram (ECG) Parameters
0; 1; 1; 0; 1; 0
SECONDARY
Stage 1 and Stage 2: Change From Baseline in Lipoarabinomannan (LAM) in the Mycobacteria Growth Indicator Tube® (MGIT) System
-1.52; -1.41; -1.44; -1.35; -1.19; -1.93
SECONDARY
Stage 1 and Stage 2: Change From Baseline in Time to Detection (TTD) in the MGIT System
4.28; 9.54; 18.15; 3.33; 7.44; 8.93
SECONDARY
Stage 2: Change From Baseline in TB Bacterial Load in Sputum as a Measure of EBA
-2.17; -1.97; -2.73
SECONDARY
Stage 2: Plasma Concentration of Rifampin
4020; 1880
SECONDARY
Stage 1: Plasma Concentration of Isoniazid
4.16; 1.58
SECONDARY
Stage 2: Cmax of DM-6705
10.3; 14.6
SECONDARY
Stage 2: Cmax,ss of DM-6705
84.0; 112
SECONDARY
Stage 2: Tmax of DM-6705
4.82; 4.83; 4.83; 4.85
SECONDARY
Stage 2: AUC0-24 for DM-6705
103; 166; 1620; 1980
SECONDARY
Stage 2: T1/2,z of DM-6705
NA; NA
SECONDARY
Stage 2: Cmax of N-Desmethyl Bedaquiline
95.4; 88.2
SECONDARY
Stage 2: Cmax,ss of N-Desmethyl Bedaquiline
489; 575
SECONDARY
Stage 2: Tmax of N-Desmethyl Bedaquiline
23.93; 11.86; 15.08; 7.83
SECONDARY
Stage 2: AUC0-24 for N-Desmethyl Bedaquiline
1380; 1410; 10100; 11800
SECONDARY
Stage 2: Number of Participants With TEAEs on Administration of OPC-167832 in Combination With Delamanid and/or Bedaquiline
9; 11; 9
SECONDARY
Stage 2: Number of Participants With Clinically Significant Vital Sign Changes on Administration of OPC-167832 in Combination With Delamanid and/or Bedaquiline
0; 1; 0; 0; 2; 0
SECONDARY
Stage 2: Number of Participants With Clinically Significant Changes in ECG Evaluations on Administration of OPC-167832 in Combination With Delamanid and/or Bedaquiline
0; 0; 0; 0; 0; 0

Summary

This trial will evaluate the safety, tolerability, pharmacokinetics (PK), and efficacy of multiple oral doses of OPC-167832 in participants with uncomplicated, smear-positive, drug-susceptible pulmonary tuberculosis (TB).

Eligibility Criteria

Inclusion Criteria

  • Able to provide written, informed consent prior to initiation of any trial-related procedures, and able, in the opinion of the investigator, to comply with all the requirements of the trial.
  • Male or female participants between 18 and 64 years of age (inclusive) at the screening visit.
  • Body mass index ≥ 16.0 and ≤ 32.0 kilograms per meters squared (kg/m^2) (inclusive) at the screening visit.
  • Newly diagnosed, uncomplicated, drug-susceptible pulmonary TB.
  • Microscopy performed on a sputum smear at screening indicates presence of acid-fast bacilli (at least 1+).
  • Able to produce an adequate volume of sputum (approximately 10 millilitres (mL) or more estimated overnight production).
  • Female participants of childbearing potential must agree to use 2 different approved methods of birth control or remain abstinent throughout the participation in the trial and for 12 weeks after the last dose of trial treatment (investigational medicinal product (IMP) or RHEZ).
  • Male participants must agree to use 2 different approved methods of birth control or remain abstinent throughout the participation in the trial and for 12 weeks after the last dose of trial treatment (IMP or RHEZ).

Exclusion Criteria

  • Participants are known or suspected of having resistance to rifampicin, isoniazid, ethambutol, or pyrazinamide using any combination of Xpert Mycobacterium tuberculosis/Rifampin (MTB/RIF), line probe assay, culture, and/or epidemiologic history at screening.
  • Poor general condition where no delay in treatment can be tolerated or where immediate hospital admission is warranted.
  • Evidence of clinically significant metabolic (including ongoing or current hypokalemia), gastrointestinal, neurological, psychiatric, endocrine or liver (e.g., hepatitis B and C) disease; malignancy; or other abnormalities (other than the indication being studied).
  • History of or current clinically relevant cardiovascular disorder such as heart failure, coronary heart disease, hypertension, arrhythmia or symptom strongly suggestive of such a problem (for example, syncope or palpitations), tachyarrhythmia or status after myocardial infarction.
  • Known bleeding disorders or family history of bleeding disorders.
  • Any diseases or conditions in which the use of delamanid, rifampicin, isoniazid, pyrazinamide, ethambutol, or Bedaquiline is contraindicated.
  • Any prior treatment for M. tuberculosis within the past 3 years.
  • Any treatment with a drug active against M. tuberculosis (e.g., quinolones) within the 3 months prior to screening.
  • Clinical evidence of severe extrapulmonary TB (e.g., miliary TB, abdominal TB, urogenital TB, osteoarthritic TB, TB meningitis).
  • Evidence of pulmonary silicosis, lung fibrosis, or other lung condition considered as severe by the investigator (other than TB). In particular any underlying condition that could interfere with the assessment of x-ray images, sputum collection, or interpretation of sputum findings, or otherwise compromise the subject's participation in the trial.
  • Any renal impairment characterized by serum creatinine clearance of 1.5 x upper limit of normal (ULN) of the clinical laboratory reference range at screening.
  • For Stage 1, participants who are human immunodeficiency virus (HIV) positive are excluded. For Stage 2, participants with HIV co-infection who are on antiretroviral drugs during screening or with CD4 cell count 450 milliseconds (msec), atrioventricular block II or III, bi-fasicular block, at screening or current history of clinically significant ventricular arrhythmias. Other ECG changes if considered clinically significant by the investigator.
  • Participants receiving any of the prohibited medications within the specified periods or who would be likely to require prohibited concomitant therapy during the trial.
  • Female participants who are breast-feeding or who have a positive pregnancy test result prior to receiving the first dose of IMP or RHEZ on Day 1.
  • History of s
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03678688). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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