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Trial registered on ANZCTR
Registration number
ACTRN12619001704189
Ethics application status
Approved
Date submitted
22/11/2019
Date registered
4/12/2019
Date last updated
4/10/2022
Date data sharing statement initially provided
4/12/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Implementing shorter treatment for latent tuberculosis in the Northern Territory
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Scientific title
Shorter regimens for treatment of latent tuberculosis in the Northern Territory: a
pragmatic effectiveness study
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Secondary ID [1]
299883
0
Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Tuberculosis
315299
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Latent tuberculosis infection
315300
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Condition category
Condition code
Infection
313600
313600
0
0
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Studies of infection and infectious agents
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Respiratory
313601
313601
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention therapy will be self-administered combination therapy for treatment of latent tuberculosis infection, consisting of 3 months of weekly oral isoniazid 900mg and weekly oral rifapentine 900mg (3HP). Patients will receive a medication tracker form to record doses and will receive weekly text message reminders. Aherance will be monitred by clinic staff at monthly clinic appointments through review of medication tracker and pill count.
The comparator group will be those receiving the current standard of care (9 months daily isoniazid). Following a baseline period of approximately 6 months of data collection under the current standard of care, the intervention therapy will be implemented and offerred to all eligible patients who are recommended to receive treatment for latent TB infection.
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Intervention code [1]
316150
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Treatment: Drugs
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Comparator / control treatment
Current standard of care: self-administered therapy for treatment of latent tuberculosis infection, consisting of 9 months of oral daily or thrice weekly isoniazid (9H), weight adjusted dose up to 300mg or 900mg maximum dose for daily or thrice weekly regimens respecitvely.
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Control group
Active
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Outcomes
Primary outcome [1]
322050
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Treatment completion rate. Treatment completion will be assessed by clinic staff through review of patient medication tracker and pill count.
For 3HP, treatment completion is defined as at least 12 valid doses (more than 72 hours apart) of rifapentine and isoniazid within 16 weeks.
For 9H, treatment completion is defined as 270 daily doses or 117 thrice weekly doses, taken within 12 months.
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Assessment method [1]
322050
0
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Timepoint [1]
322050
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End of treatment
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Secondary outcome [1]
377147
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Qualitative assessment of patient satisfaction with latent tuberculosis treatment. Patient satisfaction will be assessed through the use of semi-structured interview including visual analogue scales and qualitative assessment of open ended questions around satisfaction with treatment.
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Assessment method [1]
377147
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Timepoint [1]
377147
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End of treatment
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Secondary outcome [2]
377148
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Qualitative assessment of treatment provider satisfaction with latent tuberculosis regimens. Provider satisfaction will be assessed using an web-based survey including visual analogue scales and qualitative assessment of open ended questions.
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Assessment method [2]
377148
0
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Timepoint [2]
377148
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End of trial
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Secondary outcome [3]
377149
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Cost-effectiveness of 3HP versus 9H for treatment of latent tuberculosis infection from the healthcare perspective. Hospital medical records will be used to gather data on the resource use and cost associated with both regimens. This will be assessed for each treatment regimen as cost in AUD per patient completing therapy.
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Assessment method [3]
377149
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Timepoint [3]
377149
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End of trial
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Eligibility
Key inclusion criteria
Patients with latent tuberculosis infection diagnosed by positive tuberculin skin test (TST) or Interferon-Gamma Release Assay (IGRA), in whom active TB disease has been excluded, and there is a clinical indication for treatment of latent tuberculosis infection.
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Minimum age
2
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Children less than two years of age or body weight less than 10kg
Anyone with presumed or confired TB disease or is undergoing treatment for TB disease
Those with presumed infection with isoniazid or rifampicin resistant Mycobacterium tuberculosis
Pregnant women or women who expect to become pregnant during the twelve week course of treatment
Those taking any medication which may result in a clinically significant interaction with isoniazid or rifapentine, including people with HIV infection taking antiretroviral medications which may interact with rifapentine such as protease inhibitors or nevirapine.
Those with a history of allergic reaction or hypersensitivity to isoniazid, rifapentine or rifamycins
Those with a AST level that is three or more times higher than the upper limit of normal
Anyone under consideration for solid organ transplantation
Anyone with a history of porphyria
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
18/10/2021
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Actual
18/10/2021
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Date of last participant enrolment
Anticipated
31/12/2022
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Actual
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Date of last data collection
Anticipated
30/04/2023
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Actual
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Sample size
Target
240
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Accrual to date
41
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Final
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Recruitment in Australia
Recruitment state(s)
NT
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Funding & Sponsors
Funding source category [1]
304340
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Other Collaborative groups
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Name [1]
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HOT NORTH
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Address [1]
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John Mathews Building (Bldg 58)
Royal Darwin Hospital Campus
Rocklands Drive Casuarina NT 0810 Australia
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Country [1]
304340
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Australia
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Primary sponsor type
Government body
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Name
TB Unit, Northern Territory Centre for Disease Control
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Address
Royal Darwin Hospital
Royal Darwin Hospital Campus
Rocklands Drive Casuarina NT 0810 Australia
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Country
Australia
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Secondary sponsor category [1]
304591
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None
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Name [1]
304591
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Address [1]
304591
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Country [1]
304591
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
304792
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Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research
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Ethics committee address [1]
304792
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Menzies School of Health Research John Mathews Building (Bldg 58) Royal Darwin Hospital Campus Rocklands Drive Casuarina NT 0810 Australia
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Ethics committee country [1]
304792
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Australia
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Date submitted for ethics approval [1]
304792
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13/11/2019
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Approval date [1]
304792
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19/02/2020
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Ethics approval number [1]
304792
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2019-3595
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Summary
Brief summary
In the Northern Territory, nine-months of daily isoniazid is currently recommended for the treatment of Latent Tuberculosis Infection (LTBI), but less than 50% of those offered treatment complete it. A three-month LTBI treatment regimen consisting of 12 weekly doses of two drugs (isoniazid (H) & rifapentine (P), known as ‘3HP’) is safe and effective. This regimen shows promise for improving completion of LTBI treatment but is yet to be taken up in Australia. Darwin TB Clinic will implement 3HP for treatment of LTBI among patients in the greater Darwin area. We will evaluate the implementation of 3HP by measuring treatment completion, adverse events, cost-effectiveness, and patient and provider acceptance.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
98218
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Dr Chris Lowbridge
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Address
98218
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John Mathews Building (Building 58)
Royal Darwin Hospital Campus
Rocklands Drive, Casuarina NT 0810
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Country
98218
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Australia
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Phone
98218
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+61 08 8946 8411
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Fax
98218
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Email
98218
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[email protected]
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Contact person for public queries
Name
98219
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Chris Lowbridge
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Address
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John Mathews Building (Building 58)
Royal Darwin Hospital Campus
Rocklands Drive, Casuarina NT 0810
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Country
98219
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Australia
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Phone
98219
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+61 08 8946 8411
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Fax
98219
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Email
98219
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[email protected]
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Contact person for scientific queries
Name
98220
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Chris Lowbridge
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Address
98220
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John Mathews Building (Building 58)
Royal Darwin Hospital Campus
Rocklands Drive, Casuarina NT 0810
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Country
98220
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Australia
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Phone
98220
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+61 08 8946 8411
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Fax
98220
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Email
98220
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
There may be a risk of patient identification if IPD is shared
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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