Condition category
Infections and Infestations
Date applied
19/10/2012
Date assigned
26/02/2013
Last edited
31/03/2014
Prospective/Retrospective
Prospectively registered
Overall trial status
Completed
Recruitment status
No longer recruiting

Plain English Summary

Background and study aims
Within the UK, completion rates for latent tuberculosis infection (LTBI) treatment regimens are known to be poor. A recent paper described a novel LTBI treatment regimen of Rifapentine/Isoniazid with high completion rates. Our pilot study will compare completion rates between this novel regimen and a Rifinah regimen and will provide useful data to inform future practice. The value for money of this approach will be assessed.

Who can participate?
Participants must be male or non-pregnant, non-nursing, females between 16 years of age and 65 years. They must test positive for LTBI, but not have active tuberculosis disease, and be willing to provide signed informed consent. Individuals allergic to the study medications, who have HIV, significant liver disease, who are high risk drinkers, who are taking medications that may interact with the study drugs and who would usually have Directly Observed Treatment (DOT) are not eligible.

What does the study involve?
Participants will be randomly allocated to either twice daily Rifinah or weekly Rifapentine and Isoniazid for three months. Treatment adherence and adverse reactions will be monitored every month through clinic appointments and for one month after treatment completion.

What are the possible benefits and risks of participating?
Participants could reduce their risk of developing active tuberculosis by being treated.
Possible side effects include hepatoxicity (damage of the liver). These would be monitored during the study and the treatment would be stopped if clinically indicated.

Where is the study run from?
University College London (UK).

When is study starting and how long is it expected to run for?
The study is expected to start in April 2013 and end in September 2015. Recruitment will take place during the first 15 months.

Who is funding the study?
Department of Health (UK)

Who is the main contact?
Professor Ibrahim Abubakar
i.abubakar@ucl.ac.uk

Trial website

Contact information

Type

Scientific

Primary contact

Prof Ibrahim Abubakar

ORCID ID

Contact details

University College London
Research Department of Infection and Population Health
4th floor Mortimer Market
off Capper Street
London
WC1E 6JB
United Kingdom
+44 (0)20 7679 0954
i.abubakar@ucl.ac.uk

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

12/0426

Study information

Scientific title

The HALT LTBI study: Phase IV multi-site, unblinded, randomised trial of prophylactic Rifapentine/Isoniazid versus Rifampicin/Isoniazid (Rifinah) for latent tuberculosis infection (LTBI)

Acronym

Study hypothesis

Completion rates for individuals treated with Rifapentine/Isoniazid will be higher than for those treated with Rifinah.

On 31/03/2014 the following changes were made to the trial record:
1. The anticipated start date was changed from 01/04/2013 to 01/05/2014
2. The anticipated end date was changed from 30/09/2015 to 31/05/2015

Ethics approval

NRES Committee London, Brent, 29/11/2013, ref: 13/LO/1666

Study design

Pilot of a randomised control trial of completion of, and adverse reactions to, LTBI treatment comparing daily Rifinah for 3 months or Rifapentine/Isoniazid weekly for 3 months.

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

GP practices

Trial type

Treatment

Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet

Condition

Latent tuberculosis infection

Intervention

Random allocation to either Rifinah (300mg Rifampicin plus 150mg Isoniazid, two daily) or Rifapentine and Isoniazid (3 months, 12 weekly doses); monthly follow-up for the duration of treatment and one month after treatment completion.

Intervention type

Other

Phase

Not Applicable

Drug names

Primary outcome measures

1. Completion of treatment regimen
2. Associated health economics to determine cost effectiveness of the intervention

Secondary outcome measures

Adverse effects of treatment for LTBI

Overall trial start date

01/05/2014

Overall trial end date

31/05/2015

Reason abandoned

Eligibility

Participant inclusion criteria

1. Male or non-pregnant, non-nursing, female adults aged between 16 years 0 days and 64 years 364 at enrolment
2. Individuals at high risk for developing tuberculosis but without evidence of active tuberculosis. High-risk is defined on the basis of a positive Interferon Gamma Release Assay (IGRA).
3. People with no evidence of active tuberculosis who have a positive IGRA as defined above.
4. Willing and able to provide written informed consent.

Participant type

Patient

Age group

Adult

Gender

Both

Target number of participants

100

Participant exclusion criteria

Current exclusion criteria as of 31/03/2014:
1. Patients unable to give consent
2. Pregnant or breastfeeding women
3. Patients whose weight is under 45 kg
4. Allergies to any of the study drugs or excipients contained in preparations of these medicines
5. Patients requiring medications that cannot be safely taken with the study drugs (see Appendix 2)
6. Any medical condition deserving priority of treatment (such as: porphyria, malabsorption syndromes, Clostridium difficile-associated diarrhoea and other conditions)
7. HIV infection
8. Individuals with known liver disease, defined as LFT (ALT/AST/bilirubin) over upper limit of normal (ULN) at baseline (one abnormal value prevents the patient from participating in the study)
9. Clinical diagnosis of cirrhosis (jaundice, hematemesis, ascites or previous episodes of liver encephalopathy)
10. Chronic/active hepatitis B or hepatitis C virus infection
11. High-risk drinking, according to the Department of Health criteria (regularly drinking more than 8 units a day or 50 units a week for men; regularly drinking more than 6 units a day or 35 units a week for women)
12. Previous treatment for TB or LTBI
13. Individuals who would usually be offered LTBI treatment under Directly Observed Therapy (DOT) because of their mental or social disabilities
14. Use of another experimental investigational medicinal product that is likely to interfere with the study medication within 3 months of study enrolment

Previous exclusion criteria:
1. Females of childbearing potential must be willing to use an effective method of contraception
2. Females of childbearing potential must have a negative pregnancy test within 7 days prior to being registered for trial treatment
3. Females must not be breastfeeding
4. Allergies to Rifapentine, Isoniazid, Rifampicin or excipients contained in the preparations of these medicines
5. Patients requiring medications that cannot be safely taken with the study drugs
6. High risk drinking, according to the Department of Health criteria
7. Those who are HIV positive
8. Individuals who already have significant liver disease
9. Those who would not be eligible for LTBI treatment under the American Thoracic Society Criteria
10. Individuals who would usually be offered LTBI treatment under Directly Observed Therapy (DOT)

Recruitment start date

01/05/2014

Recruitment end date

31/05/2015

Locations

Countries of recruitment

United Kingdom

Trial participating centre

University College London
London
WC1E 6JB
United Kingdom

Sponsor information

Organisation

University College London (UK)

Sponsor details

c/o Anne Marie Downey
Joint Research Office
1st Floor Maple House (Suite A)
149 Tottenham Court Road
London
W1T 7DN
United Kingdom

Sponsor type

University/education

Website

http://www.ucl.ac.uk/

Funders

Funder type

Government

Funder name

Department of Health Policy Research Programme (UK) ref: 015/0306

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

Publication citations

Additional files

Editorial Notes