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This is a multi-center, randomized, parallel, open-label, positive-controlled Phase 2 clinical trial, which aims to evaluate the early bactericidal activity, safety and tolerability of WX-081 in patients with drug-naive&susceptible and drug-resistant tuberculosis. Also the efficacy of WX-081 will be explored in participants with drug-resistant tuberculosis.
This is a Phase 2, multi-center, randomized, parallel, open-label, positive-controlled clinical trial. The objective of this trial is to evaluate the early bactericidal activity, safety and tolerability of WX-081 patients with drug-naive&susceptible and drug-resistant tuberculosis. and the efficacy in participants with drug-resistant tuberculosis.
This trial will be divided into core research stage (stage 1) and extended research stage (stage 2). During stage 1, a panel of 59 participants with drug-naive&susceptible tuberculosis will be randomized to receive either WX-081(including 3 groups:150mg qd, 300mg qd, 450mg qd. n=12 per group) or standard treatment (n=8) for 2 weeks, and then followed by a follow-up period of 2 weeks. A panel of 40 participants with drug-resistant tuberculosis will be randomized to receive either WX-081 (400mg qd, n=20) or bedaquiline (400mg qd, n=20) for 2 weeks. During stage 2, the 40 participants with drug-resistant tuberculosis will receive WX-081(150mg qd) + MBT treatment (ie. multi-drug background treatment) and bedaquiline (200mg tiw) +MBT treatment for 6 weeks respectively, and then followed by a follow-up period of 4 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm A: WX-081 | Experimental | Participants with newly-treated drug sensitivity tuberculosis receive WX-081 150mg orally once daily for 2 weeks. |
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| Arm B: WX-081 | Experimental | Participants with newly-treated drug sensitivity tuberculosis receive WX-081 300mg orally once daily for 2 weeks. |
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| Arm C: WX-081 | Experimental | Participants with newly-treated drug sensitivity tuberculosis receive WX-081 450mg orally once daily for 2 weeks. |
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| Arm D: Standard treatment | Active Comparator | Participants with newly-treated drug sensitivity tuberculosis receive standard treatment for two weeks. |
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| Arm E: WX-081+MBT | Experimental | Participants with drug-resistant tuberculosis receive WX-081 400mg orally once daily for 2 weeks, and then MBT+ WX-081 150mg orally once daily for 6 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| WX-081 | Drug | WX-081 is not licensed yet. WX-081 will be used in arms A, B, C, WX-081+MBT. |
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| Measure | Description | Time Frame |
|---|---|---|
| Time to positive (TTP) | TTP is measured as time to sputum culture positivity in Liquid Culture Media. | Day 0-14. |
| Early bactericidal activity (EBA) of WX-081 | EBA is measured as the mean rate of colony forming unit (log10CFU) of mycobacterium tuberculosis per ml sputum on solid medium in different time periods. | Day 0-14. |
| Measure | Description | Time Frame |
|---|---|---|
| change of electrocardiogram QT interval | QT interval is calculated as QTcF in milliseconds (ms) | Measured through 8 Weeks. |
| The percentage of participants with sputum culture-negative conversion. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Song AiYun, MD | Shang hai Jiatan Pharma | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Chest Hospital affiliated to Capital Medical University | Beijing | Beijing Municipality | 101149 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35636648 | Derived | Huang Z, Luo W, Xu D, Guo F, Yang M, Zhu Y, Shen L, Chen S, Tang D, Li L, Li Y, Wang B, Franzblau SG, Ding CZ. Discovery and preclinical profile of sudapyridine (WX-081), a novel anti-tuberculosis agent. Bioorg Med Chem Lett. 2022 Sep 1;71:128824. doi: 10.1016/j.bmcl.2022.128824. Epub 2022 May 27. |
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| ID | Term |
|---|---|
| D014397 | Tuberculosis, Pulmonary |
| D014376 | Tuberculosis |
| ID | Term |
|---|---|
| D009164 | Mycobacterium Infections |
| D000193 | Actinomycetales Infections |
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
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| ID | Term |
|---|---|
| C000723535 | sudapyridine |
| C493870 | bedaquiline |
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Parallel Assignment
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| Arm F: Bedaquiline+MBT |
| Active Comparator |
Participants with drug-resistant tuberculosis receive Bedaquiline 400mg orally once daily for 2 weeks, and then MBT+ Bedaquiline 200mg orally 3 times per week for 6 weeks. |
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| Bedaquiline | Drug | This licensed drug will be used in arm F as positive comparator. |
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| Standard treatment | Drug | Standard treatment will be used in arm D as positive comparator, according to the recommendations of WHO guidelines for diagnosis and treatment of tuberculosis. |
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| Multi-drug background treatment (MBT) | Drug | MBT will be used in arm E, F as background treatment. The drugs used in MBT are all licensed drugs, and the treatment complies with the recommendations of WHO guidelines for diagnosis and treatment of tuberculosis. |
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Percentage of participants with an occurrence of sputum culture-negative through 8 weeks.
| Measured through 8 Weeks. |
| Rate of change of colony forming units (CFU) | Rate of change of colony forming units (CFU) of mycobacterium tuberculosis on sputum culture through 8 weeks. | Measured through 8 Weeks. |
| The percentage of participants with sputum smear-negative conversion. | Percentage of participants with an occurrence of sputum smear-negative through 8 weeks. | Measured through 8 Weeks. |
| heart rate | heart rate in times per minute. | Measured through 8 Weeks. |
| blood pressure | blood pressure in mmHg | Measured through 8 Weeks. |
| Maximum plasma concentration (Cmax) | Blood samples will be taken at different time points before and after administration on Day1 and Day14 of treatment. | At day1 and 14. |
| Time to reach maximum plasma concentration (Tmax) | Blood samples will be taken at different time points before and after administration on Day1 and Day14 of treatment. | At day1 and 14. |
| Area under the plasma concentration versus time curve (AUC(0-t)) | Blood samples will be taken at different time points before and after administration on Day1 and Day14 of treatment. | At day1 and 14. |
| Terminal plasma half-life (t1/2) | Blood samples will be taken at different time points before and after administration on Day1 and Day14 of treatment. | At day1 and 14. |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D012141 | Respiratory Tract Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |