|
审核状态: Project audit state: |
通过审核 Successful |
|
注册号: Registration number: |
ChiCTR2500114092 |
|
最近更新日期: Date of Last Refreshed on: |
2025-12-08 09:44:04 |
|
注册时间: Date of Registration: |
2025-12-08 00:00:00 |
|
注册号状态: |
预注册 |
|
Registration Status: |
Prospective registration |
|
注册题目: |
固定剂量复合制剂(FDC)与单方组合方案治疗初治肺结核的随机对照研究 |
|
Public title: |
A randomized controlled study comparing fixed-dose combination (FDC) with single-drug combination regimens in the treatment of newly diagnosed pulmonary tuberculosis |
|
注册题目简写: |
|
|
English Acronym: |
|
|
研究课题的正式科学名称: |
固定剂量复合制剂(FDC)与单方组合方案治疗初治肺结核的随机对照研究 |
|
Scientific title: |
A randomized controlled study comparing fixed-dose combination (FDC) with single-drug combination regimens in the treatment of newly diagnosed pulmonary tuberculosis |
|
研究课题代号(代码): Study subject ID: |
|
|
在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
|
申请注册联系人: |
杨新婷 |
研究负责人: |
李亮; 杨新婷 |
|
Applicant: |
Yang Xinting |
Study leader: |
Li Liang; Yang Xinting |
|
申请注册联系人电话: Applicant telephone: |
+86 186 5858 5278 |
研究负责人电话: Study leader's telephone: |
+86 159 1108 6290 |
|
申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
||
|
申请注册联系人电子邮件: Applicant E-mail: |
905460979@qq.com |
研究负责人电子邮件: Study leader's E-mail: |
2320652139@qq.com |
|
申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
||
|
申请注册联系人通讯地址: |
北京市通州区北关大街9号 |
研究负责人通讯地址: |
北京市通州区北关大街9号 |
|
Applicant address: |
No. 9, Beiguan Street, Tongzhou District, Beijing |
Study leader's address: |
No. 9, Beiguan Street, Tongzhou District, Beijing |
|
申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
||
|
申请人所在单位: |
首都医科大学附属北京胸科医院 |
||
|
Applicant's institution: |
Beijing Chest Hospital, Capital Medical University |
||
|
研究负责人所在单位: |
首都医科大学附属北京胸科医院 |
||
|
Affiliation of the Leader: |
Beijing Chest Hospital, Capital Medical University |
||
|
是否获伦理委员会批准: |
是/Yes |
||
|
Approved by ethic committee: |
Yes |
||
|
伦理委员会批件文号: Approved No. of ethic committee: |
(2025)年IIT临审第(016-01)号 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
|
批准本研究的伦理委员会名称: |
首都医科大学附属北京胸科医院伦理委员会 |
||
|
Name of the ethic committee: |
Ethics Committee of Beijing Chest Hospital, Capital Medical University |
||
|
伦理委员会批准日期: Date of approved by ethic committee: |
2025-11-03 00:00:00 |
||
|
伦理委员会联系人: |
张彤群 |
||
|
Contact Name of the ethic committee: |
Zhang Tongqun |
||
|
伦理委员会联系地址: |
北京市通州区北关大街9号 |
||
|
Contact Address of the ethic committee: |
No. 9, Beiguan Street, Tongzhou District, Beijing |
||
|
伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 10 8950 9134 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
|
|
研究实施负责(组长)单位: |
首都医科大学附属北京胸科医院 |
||||||||||||||||||||||
|
Primary sponsor: |
Beijing Chest Hospital, Capital Medical University |
||||||||||||||||||||||
|
研究实施负责(组长)单位地址: |
北京市通州区北关大街9号 |
||||||||||||||||||||||
|
Primary sponsor's address: |
No. 9, Beiguan Street, Tongzhou District, Beijing |
||||||||||||||||||||||
|
试验主办单位(项目批准或申办者): Secondary sponsor: |
|
||||||||||||||||||||||
|
经费或物资来源: |
企业资助 |
||||||||||||||||||||||
|
Source(s) of funding: |
Corporate sponsorship |
||||||||||||||||||||||
|
Target disease: |
tuberculosis |
||||||||||||||||||||||
|
Target disease code: |
|
||||||||||||||||||||||
|
研究类型: |
干预性研究 |
||||||||||||||||||||||
|
Study type: |
Interventional study |
||||||||||||||||||||||
|
研究所处阶段: |
其它 | ||||||||||||||||||||||
|
Study phase: |
N/A |
||||||||||||||||||||||
|
研究设计: |
随机平行对照 |
||||||||||||||||||||||
|
Study design: |
Parallel |
||||||||||||||||||||||
|
研究目的: |
主要目的: 评估在每日给药模式下,固定剂量复合制剂(FDC)方案(强化期使用含异烟肼、利福平、吡嗪酰胺、乙胺丁醇的四联或三联FDC,巩固期使用含异烟肼、利福平的二联FDC)治疗初治药物敏感肺结核的疗效、安全性和依从性,并确证其相较于标准的每日给药单方组合方案的非劣效性。本研究旨在为FDC每日给药方案在我国初治肺结核患者中的广泛应用提供高级别的循证医学证据。 次要目的: 远期疗效:比较FDC组与单方组合方案组在治疗开始后24个月的良好结局发生率。 安全性:系统比较两组的安全性特征,包括严重不良事件(SAE)发生率、因不良事件(AE)导致的治疗中断或方案调整率,以及根据CTCAE5.0标准分级的各类AE的发生情况。 依从性:通过药片计数法,定量比较两组患者在治疗过程中的药物依从性。 影像学改善:由两名独立的、对分组信息设盲的放射科医生评估治疗6个月时的胸部CT影像,比较两组的影像学改善率。 药代动力学:在一个预设的亚组中,检测并比较两组在不同体重分层(低、中、高)患者中的稳态血药峰浓度(Cmax),评估其是否达到公认的治疗窗范围,并探究FDC制剂对药物暴露量的影响。 |
||||||||||||||||||||||
|
Objectives of Study: |
Primary objective: To evaluate the efficacy, safety, and adherence of a fixed-dose combination (FDC) regimen administered daily (using a quadruple or triple FDC containing isoniazid, rifampicin, pyrazinamide, and ethambutol during the intensive phase, and a dual FDC containing isoniazid and rifampicin during the consolidation phase) in the treatment of newly diagnosed drug-sensitive pulmonary tuberculosis, and to confirm its non-inferiority compared to the standard daily-administered single-drug combination regimen. This study aims to provide high-level evidence-based medical evidence for the widespread application of the daily FDC regimen in newly diagnosed tuberculosis patients in China. Secondary objectives: Long-term efficacy: To compare the incidence of favorable outcomes between the FDC group and the single-drug combination regimen group at 24 months after the start of treatment. Safety: To systematically compare the safety profiles of the two groups, including the incidence of serious adverse events (SAEs), the rate of treatment discontinuation or regimen adjustment due to adverse events (AEs), and the occurrence of various AEs graded according to the CTCAE 5.0 criteria. Adherence: To quantitatively compare the medication adherence of patients in the two groups during treatment using the pill counting method. Imaging improvement: Chest CT images at 6 months of treatment will be evaluated by two independent radiologists blinded to group assignment to compare the imaging improvement rates between the two groups. Pharmacokinetics: In a predefined subgroup, measure and compare the steady-state peak plasma concentrations (Cmax) in patients with different weight stratifications (low, medium, high) between the two groups, assess whether they fall within the recognized therapeutic window, and investigate the impact of FDC formulations on drug exposure. |
||||||||||||||||||||||
|
药物成份或治疗方案详述: |
|
||||||||||||||||||||||
|
Description for medicine or protocol of treatment in detail: |
|
||||||||||||||||||||||
|
纳入标准: |
受试者必须同时满足以下所有标准方可入组: 符合《2017年肺结核诊断标准》中临床诊断或确定诊断标准的初治肺结核患者。 年龄在18至65周岁之间(含边界值),性别不限。 受试者充分理解本研究并自愿参加,签署了书面知情同意书。 |
||||||||||||||||||||||
|
Inclusion criteria |
Participants must meet all of the following criteria to be enrolled in the study: Newly treated pulmonary tuberculosis patients who meet the criteria for clinical diagnosis or confirmed diagnosis in the "2017 Diagnostic Criteria for Tuberculosis". Aged between 18 and 65 years old (inclusive of the boundary values), regardless of gender. Participants fully understand the study, voluntarily participate in it, and have signed a written informed consent form. |
||||||||||||||||||||||
|
排除标准: |
受试者如符合以下任一标准,则不能入组: 患有播散性肺结核或广泛病变肺结核(定义为病变累积范围大于1/2肺野或存在肺叶损毁)。 合并严重的活动性肺外结核,如颅脑结核、骨关节结核、气管支气管结核、脓肿型淋巴结结核、泌尿生殖系统结核、结核性脓胸或包裹性积液等。 对本研究涉及的任何一种一线抗结核药物(异烟肼、利福平、吡嗪酰胺、乙胺丁醇)有已知的过敏史或严重不耐受史。 基线或入组后经基因型或表型药敏试验证实对异烟肼或利福平耐药;或虽无细菌学证据,但有明确的耐药肺结核患者密切接触史或其他耐药高风险因素。 女性受试者处于妊娠期、哺乳期,或计划在研究期间妊娠。 人类免疫缺陷病毒(HIV)抗体阳性者。此项排除旨在避免抗逆转录病毒药物与利福平之间复杂的药物相互作用(利福平是肝脏细胞色素P450酶的强诱导剂),以免对任一治疗方案的疗效和安全性评估产生干扰。 筛选期存在显著肝功能异常,定义为丙氨酸氨基转移酶(ALT)或天冬氨酸氨基转移酶(AST)> 1.5倍正常值上限(ULN),或总胆红素(TBIL)> ULN;或合并基础性肝病,包括酒精性肝病、自身免疫性肝病、慢性肝炎活动期、肝硬化等。此项排除是基于一线抗结核药物(特别是异烟肼、利福平和吡嗪酰胺)均具有潜在肝毒性的标准安全性考量。 存在肾功能不全,定义为肌酐清除率低于60 mL/min。此项排除旨在避免经肾脏排泄的药物(如乙胺丁醇及其代谢物)在体内蓄积,增加毒性风险。 合并严重或未受控制的其他系统疾病,如心血管疾病、脑血管疾病、其他呼吸系统疾病、精神疾病、痛风或重度糖尿病(糖化血红蛋白>8.5%)。 有视神经炎病史、色觉障碍,或无法配合视力检查者。此为针对乙胺丁醇潜在视神经毒性风险的特异性排除标准。 在筛选前4周内,正在或计划参加任何其他干预性临床试验。 研究者根据其临床判断,认为受试者存在任何其他不适合参加本研究的情况。 |
||||||||||||||||||||||
|
Exclusion criteria: |
Subjects who meet any of the following criteria will be excluded from enrollment: - Suffering from disseminated pulmonary tuberculosis or pulmonary tuberculosis with extensive lesions (defined as lesions involving more than 1/2 of the lung field or presence of lung lobe destruction). - Complicated with severe active extrapulmonary tuberculosis, such as craniocerebral tuberculosis, osteoarticular tuberculosis, tracheobronchial tuberculosis, abscess-type lymph node tuberculosis, genitourinary tuberculosis, tuberculous empyema, or encapsulated effusion, etc. - Having a known history of allergy or severe intolerance to any of the first-line anti-tuberculosis drugs involved in this study (isoniazid, rifampicin, pyrazinamide, ethambutol). - Confirmed resistance to isoniazid or rifampicin by genotypic or phenotypic drug susceptibility testing at baseline or after enrollment; or having a clear history of close contact with drug-resistant pulmonary tuberculosis patients or other high-risk factors for drug resistance, even without bacteriological evidence. - Female subjects who are pregnant, lactating, or planning to become pregnant during the study period. - Those with positive human immunodeficiency virus (HIV) antibodies. This exclusion is intended to avoid complex drug interactions between antiretroviral drugs and rifampicin (rifampicin is a strong inducer of hepatic cytochrome P450 enzymes), so as not to interfere with the evaluation of the efficacy and safety of any treatment regimen. - Having significant liver function abnormalities during the screening period, defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 1.5 times the upper limit of normal (ULN), or total bilirubin (TBIL) > ULN; or complicated with underlying liver diseases, including alcoholic liver disease, autoimmune liver disease, active chronic hepatitis, cirrhosis, etc. This exclusion is based on standard safety considerations that first-line anti-tuberculosis drugs (especially isoniazid, rifampicin, and pyrazinamide) all have potential hepatotoxicity. - Having renal insufficiency, defined as a creatinine clearance rate below 60 mL/min. This exclusion is intended to avoid the accumulation of drugs excreted through the kidneys (such as ethambutol and its metabolites) in the body, increasing the risk of toxicity. - Complicated with severe or uncontrolled diseases of other systems, such as cardiovascular diseases, cerebrovascular diseases, other respiratory diseases, mental diseases, gout, or severe diabetes (glycated hemoglobin > 8.5%). - Having a history of optic neuritis, color vision impairment, or being unable to cooperate with vision examinations. This is a specific exclusion criterion for the potential risk of optic nerve toxicity associated with ethambutol. - Currently participating in or planning to participate in any other interventional clinical trial within 4 weeks before screening. - In the investigator's clinical judgment, the subject has any other conditions that make them unsuitable for participation in this study. |
||||||||||||||||||||||
|
研究实施时间: Study execute time: |
从 From 2025-11-30 00:00:00至 To 2028-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2025-12-15 00:00:00 至 To 2026-06-30 00:00:00 |
|
干预措施: Interventions: |
|
|
研究实施地点: Countries of recruitment and research settings: |
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
测量指标: Outcomes: |
|
|
采集人体标本:
Collecting sample(s)
|
|
|
征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
|
||||||
|
性别: |
男女均可 |
Gender: |
Both |
||||||
|
随机方法(请说明由何人用什么方法产生随机序列): |
确认合格的受试者将由研究人员登录中央随机化系统录入其基本信息。系统将即时生成唯一的随机号,并根据预设的分层区组随机序列(按中心分层,区组大小为4)将受试者以1:1的比例分配至FDC组或单方组合方案组。该系统确保了分配方案的隐藏,避免了选择偏倚。 |
||||||||
|
Randomization Procedure (please state who generates the random number sequence and by what method): |
Eligible subjects confirmed will have their basic information entered into the central randomization system by researchers. The system will immediately generate a unique random number and assign subjects to either the FDC group or the single-agent combination regimen group in a 1:1 ratio according to a preset stratified block random sequence (stratified by center, with a block size of 4). This system ensures the concealment of the allocation scheme and avoids selection bias. |
||||||||
|
是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
公开/Public |
|
盲法: |
无 |
|
Blinding: |
No |
|
试验完成后的统计结果(上传文件): |
|
|
Calculated Results after
|
|
|
是否共享原始数据: IPD sharing |
No |
|
共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
无 |
|
The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
No |
|
数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
采用电子采集和管理系统 |
|
Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Adopt an electronic collection and management system |
|
数据与安全监察委员会: Data and Safety Monitoring Committee: |
暂未确定/Not yet |