Phase 2
N=122
A Phase 1/2 Trial of Multiple Oral Doses of OPC-167832 for Uncomplicated Pulmonary Tuberculosis
Pulmonary TB
Bottom Line
View on ClinicalTrials.gov: NCT03678688 ↗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
| Outcome | Result | p-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
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.