A Phase 3 interventional study of Rifapentine and Moxifloxacin in Tuberculosis, sponsored by Centers for Disease Control and Prevention. Completed at 3 sites in 3 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-27.
Sponsored by Centers for Disease Control and Prevention · Phase 3, Interventional, and Treatment
The Tuberculosis Trials Consortium (TBTC) Study 31 is a phase 3 trial evaluating rifapentine-containing regimens for treatment-shortening of drug-susceptible pulmonary tuberculosis. This pharmacokinetic/pharmacodynamic (PK/PD) substudy evaluates rifapentine and moxifloxacin exposure-response relationships for efficacy and safety outcomes. Intensive and sparse PK sampling are performed among participants receiving rifapentine-containing regimens. PK and clinical outcomes data are used to characterize population pharmacokinetics and assess relationships between drug exposure, culture conversion, treatment failure or relapse, and adverse events.
This pharmacokinetic/pharmacodynamic (PK/PD) substudy is conducted within TBTC Study 31, a phase 3 randomized trial evaluating rifapentine-containing regimens for treatment-shortening of drug-susceptible pulmonary tuberculosis.
The substudy evaluates population pharmacokinetics and exposure-response relationships for rifapentine and moxifloxacin administered in rifapentine-containing multidrug regimens. Rifapentine is administered at a daily dose of 1200 mg with food, with or without moxifloxacin.
Participants undergo intensive and sparse pharmacokinetic sampling between Weeks 2 and 8 of treatment. Intensive PK sampling includes serial plasma collections over approximately 24 hours in a subset of participants, with additional later sampling performed after at least 14 days. Sparse PK sampling is performed in the remaining Study 31 participants.
Population PK models are developed using nonlinear mixed-effects methods to estimate individual exposure parameters including area under the concentration-time curve (AUC0-24) and maximum concentration (Cmax). PK/PD analyses evaluate relationships between drug exposure and efficacy outcomes, including culture conversion and treatment failure or relapse, as well as safety outcomes including grade 3 or higher adverse events.
The study also evaluates the effect of covariates including demographic and clinical factors on rifapentine and moxifloxacin pharmacokinetics.
1,170 studies on the registry are indexed under Tuberculosis; 175 are open to participants now.
This study's enrollment of 2,516 is above the median of 150 across 820 interventional studies indexed under Tuberculosis.
Browse Tuberculosis studies →Centers for Disease Control and Prevention is the lead sponsor of 275 studies on the registry; 2 are open to participants now.
Of its 11 completed or terminated interventional studies of FDA-regulated products, 8 (73%) have results posted.
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Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Eight weeks of daily treatment with rifampin, isoniazid, pyrazinamide, and ethambutol, followed by Eighteen weeks of daily treatment with rifampin and isoniazid. All drugs are administered orally, seven days/week, directly observed by a health care worker at least five of the seven days each week. Pyridoxine (vitamin B6), 25 or 50 mg, is administered with each study dose. Study drug doses: rifampin, 600 mg; isoniazid, 300 mg; pyrazinamide, \< 55kg 1000 mg, \>= 55-75 kg 1500 mg, \>75 kg 2000 mg; ethambutol, \< 55kg 800 mg, \>= 55-75 kg 1200 mg, \>75 kg 1600 mg.
Drug: Rifampin · Drug: Isoniazid · Drug: Pyrazinamide · Drug: Ethambutol · Dietary Supplement: Pyridoxine
Eight weeks of daily treatment with rifapentine, isoniazid, pyrazinamide, and ethambutol, followed by Nine weeks of daily treatment with rifapentine and isoniazid. All drugs are administered orally, seven days/week, directly observed by a health care worker at least five of the seven days each week. Pyridoxine (vitamin B6), 25 or 50 mg, is administered with each study dose. Study drug doses: rifapentine 1200 mg; isoniazid, 300 mg; pyrazinamide, \< 55kg 1000 mg, \>= 55-75 kg 1500 mg, \>75 kg 2000 mg; ethambutol, \< 55kg 800 mg, \>= 55-75 kg 1200 mg, \>75 kg 1600 mg.
Drug: Rifapentine · Drug: Isoniazid · Drug: Pyrazinamide · Drug: Ethambutol · Dietary Supplement: Pyridoxine
Eight weeks of daily treatment with rifapentine, isoniazid, pyrazinamide, and moxifloxacin, followed by Nine weeks of daily treatment with rifapentine, isoniazid, and moxifloxacin. All drugs are administered orally, seven days/week, directly observed by a health care worker at least five of the seven days each week. Pyridoxine (vitamin B6), 25 or 50 mg, is administered with each study dose. Study drug doses: rifapentine 1200 mg; isoniazid, 300 mg; pyrazinamide, \< 55kg 1000 mg, \>= 55-75 kg 1500 mg, \>75 kg 2000 mg; moxifloxacin, 400 mg.
Drug: Rifapentine · Drug: Moxifloxacin · Drug: Isoniazid · Drug: Pyrazinamide · Dietary Supplement: Pyridoxine
A rifamycin with activity against Mycobacterium tuberculosis
Also known as: Priftin
A fluoroquinolone
A rifamycin with activity against Mycobacterium tuberculosis
An anti-tuberculosis agent
An anti-tuberculosis agent
An anti-tuberculosis agent
An essential vitamin
Also known as: Vitamin B6
Rifapentine Area Under the Concentration-Time Curve From 0 to 24 Hours (AUC0-24)
To characterize rifapentine exposure (AUC0-24) using population pharmacokinetics.
Time frame: Plasma concentrations measured at approximately 0.5, 3, 5, 9, 12, and 24 hours after the pharmacokinetic reference dose during Weeks 2-8 after treatment initiation.
Rifapentine Maximum Plasma Concentration (Cmax)
To characterize rifapentine peak concentration using population pharmacokinetic modeling.
Time frame: Plasma concentrations measured during 0-24 hours following the pharmacokinetic reference dose; PK sampling performed during Weeks 2-8 after treatment initiation.
Number of Participants With TB-Related Unfavorable Outcomes in the Rifapentine-Moxifloxacin Regimen
Number of microbiologically eligible participants with TB-related unfavorable outcomes in the rifapentine-moxifloxacin regimen through 12 months after treatment initiation. Associations with rifapentine and moxifloxacin exposures are reported in separate Statistical Analyses.
Time frame: Efficacy assessed through 12 months after treatment initiation; pharmacokinetics assessed during Weeks 2-8.
Number of Participants With Grade 3 or Higher Adverse Events
Number of participants with grade 3 or higher adverse events during the treatment period in each rifapentine-containing treatment arm. Associations with rifapentine and moxifloxacin exposures are reported in separate Statistical Analyses.
Time frame: Pharmacokinetics assessed Weeks 2-8; Safety assessed from randomization through treatment period, up to 14 days after last dose.
Moxifloxacin Area Under the Concentration-Time Curve at Steady State
To characterize moxifloxacin pharmacokinetics when moxifloxacin was administered 400 mg daily with rifapentine 1200 mg daily.
Time frame: Weeks 2 through 8 after treatment initiation.
Number of Participants With Grade 3 or Higher Adverse Events in the Rifapentine-Moxifloxacin Regimen
Number of participants with grade 3 or higher adverse events in the rifapentine-moxifloxacin regimen during the treatment period. The association between moxifloxacin exposure and safety outcomes was evaluated using multivariable logistic regression and is reported in the Statistical Analysis section.
Time frame: Pharmacokinetics assessed Weeks 2-8; Safety assessed from randomization through treatment period, up to 14 days after last dose.
Participants were enrolled at 34 clinical research sites in 13 countries between January 2016 and October 2018. First participant was enrolled on 25 January 2016. Last participant was enrolled on 30 October 2018
| Milestone | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) |
|---|---|---|---|
| Started | 829 | 838 | 849 |
| Microbiologically eligible analysis population | 768 | 784 | 791 |
| Assessable analysis population | 726 | 752 | 756 |
| Completed | 661 | 702 | 689 |
| Not completed | 168 | 136 | 160 |
| Withdrew: Death | 7 | 3 | 3 |
| Withdrew: Lost to follow-up | 8 | 2 | 2 |
| Withdrew: Pregnancy | 8 | 4 | 5 |
| Withdrew: Baseline drug resistance | 49 | 40 | 51 |
| Withdrew: No baseline positive m. tuberculosis culture | 4 | 6 | 3 |
| Withdrew: Adverse event | 8 | 9 | 16 |
| Withdrew: Consent withdrawn no ae reported | 14 | 11 | 15 |
| Withdrew: Consent withdrawn after occurrence of ae | 2 | 3 | 3 |
| Withdrew: Treatment changed for other reasons | 7 | 4 | 4 |
| Withdrew: Baseline drug resistance | 49 | 40 | 51 |
| Withdrew: No baseline positive culture | 4 | 6 | 3 |
| Withdrew: Protocol violation | 8 | 8 | 4 |
To characterize rifapentine exposure (AUC0-24) using population pharmacokinetics.
| µg*h/mL | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) |
|---|---|---|
| Rifapentine Area Under the Concentration-Time Curve From 0 to 24 Hours (AUC0-24) | 562.4 (302 to 1037) | 557.1 (276 to 983) |
To characterize rifapentine peak concentration using population pharmacokinetic modeling.
| µg/mL | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM |
|---|---|---|
| Rifapentine Maximum Plasma Concentration (Cmax) | 32.4 (19.5 to 53.4) | 32.8 (19.2 to 51.9) |
Number of microbiologically eligible participants with TB-related unfavorable outcomes in the rifapentine-moxifloxacin regimen through 12 months after treatment initiation. Associations with rifapentine and moxifloxacin exposures are reported in separate Statistical Analyses.
| Participants | Regimen 3 (2HPZM/2HPM) |
|---|---|
| Number of Participants With TB-Related Unfavorable Outcomes in the Rifapentine-Moxifloxacin Regimen | 45 |
Number of participants with grade 3 or higher adverse events during the treatment period in each rifapentine-containing treatment arm. Associations with rifapentine and moxifloxacin exposures are reported in separate Statistical Analyses.
| participants | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) |
|---|---|---|
| Number of Participants With Grade 3 or Higher Adverse Events | 119 | 159 |
To characterize moxifloxacin pharmacokinetics when moxifloxacin was administered 400 mg daily with rifapentine 1200 mg daily.
| µg*h/mL | Regimen 3 (2HPZM/2HPM) |
|---|---|
| Moxifloxacin Area Under the Concentration-Time Curve at Steady State | 24.3 (15.2 to 45.4) |
Number of participants with grade 3 or higher adverse events in the rifapentine-moxifloxacin regimen during the treatment period. The association between moxifloxacin exposure and safety outcomes was evaluated using multivariable logistic regression and is reported in the Statistical Analysis section.
| participants | Regimen 3 (2HPZM/2HPM) |
|---|---|
| Number of Participants With Grade 3 or Higher Adverse Events in the Rifapentine-Moxifloxacin Regimen | 159 |
Collected over From randomization to up to 14 days after last dose of study treatment (4 months or 6 months plus up to 14 days). Non-serious events are listed at a 3% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Regimen 1 (2HRZE/4HR) | 7/825 (0.8%) | 56/825 (6.8%) | 74/825 (9%) |
| Regimen 2 (2HPZ/2HP) | 4/835 (0.5%) | 39/835 (4.7%) | 61/835 (7.3%) |
| Regimen 3 (2HPZM/2HPM) | 3/846 (0.4%) | 37/846 (4.4%) | 94/846 (11.1%) |
| Event | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) |
|---|---|---|---|
| HEPATITISHepatobiliary disorders | 10/825 | 5/835 | 7/846 |
| HAEMOPTYSISRespiratory, thoracic and mediastinal disorders | 5/825 | 4/835 | 1/846 |
| NEUTROPENIABlood and lymphatic system disorders | 3/825 | 1/835 | 2/846 |
| DEEP VEIN THROMBOSISVascular disorders | 3/825 | 2/835 | 1/846 |
| PREGNANCYPregnancy, puerperium and perinatal conditions | 2/825 | 3/835 | 2/846 |
| PNEUMONIAInfections and infestations | 1/825 | 1/835 | 3/846 |
| URTICARIASkin and subcutaneous tissue disorders | 0/825 | 1/835 | 3/846 |
| PULMONARY EMBOLISMRespiratory, thoracic and mediastinal disorders | 2/825 | 1/835 | 0/846 |
| STAB WOUNDInjury, poisoning and procedural complications | 1/825 | 2/835 | 0/846 |
| DIABETIC RETINOPATHYEye disorders | 1/825 | 0/835 | 0/846 |
| Event | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) |
|---|---|---|---|
| NEUTROPENIABlood and lymphatic system disorders | 48/825 | 34/835 | 56/846 |
| HepatitisHepatobiliary disorders | 26/825 | 27/835 | 38/846 |
Microbiologically eligible analysis population
| Age, Categorical(Participants) | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) | Total |
|---|---|---|---|---|
| <=18 years | 19 | 19 | 25 | 63 |
| Between 18 and 65 years | 743 | 755 | 755 | 2253 |
| >=65 years | 6 | 10 | 11 | 27 |
| Age, Continuous(years) | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) | Total |
|---|---|---|---|---|
| Median | 30.9 (24.9 to 41.0) | 31 (24.6 to 41.2) | 31 (24.6 to 41.5) | 31 (24.6 to 41.3) |
| Sex: Female, Male(Participants) | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) | Total |
|---|---|---|---|---|
| Female | 224 | 221 | 228 | 673 |
| Male | 544 | 563 | 563 | 1670 |
| Ethnicity (NIH/OMB)(Participants) | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) | Total |
|---|---|---|---|---|
| Hispanic or Latino | 27 | 20 | 27 | 74 |
| Not Hispanic or Latino | 287 | 283 | 297 | 867 |
| Unknown or Not Reported | 454 | 481 | 467 | 1402 |
| Race (NIH/OMB)(Participants) | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) | Total |
|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 | 0 |
| Asian | 86 | 93 | 89 | 268 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 |
| Black or African American | 553 | 571 | 552 | 1676 |
| White | 15 | 8 | 13 | 36 |
| More than one race | 111 | 111 | 135 | 357 |
| Unknown or Not Reported | 3 | 1 | 2 | 6 |
| Region of Enrollment(participants) | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) | Total |
|---|---|---|---|---|
| Africa | 565 | 573 | 578 | 1716 |
| East Asia | 86 | 89 | 88 | 263 |
| South America | 109 | 115 | 115 | 339 |
| United States | 8 | 7 | 10 | 25 |
| HIV status at baseline(Participants) | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) | Total |
|---|---|---|---|---|
| HIV Negative | 704 | 716 | 729 | 2149 |
| HIV Positive | 64 | 68 | 62 | 194 |
| Cavitation status at baseline(Participants) | Regimen 1 (2HRZE/4HR) | Regimen 2 (2HPZ/2HP) | Regimen 3 (2HPZM/2HPM) | Total |
|---|---|---|---|---|
| Cavitation on chest radiograph | 558 | 573 | 572 | 1703 |
| No cavitation on chest radiograph | 204 | 205 | 210 | 619 |
| Unknown | 6 | 6 | 9 | 21 |
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: Yes — De-identified participant data underlying published results may be made available through an approved data sharing platform following publication and sponsor approval.
Time frame: Following publication.
Access criteria: Access may be provided to qualified researchers upon request and approval by the study sponsor and data access committee.
Ran from Jan 2016 to primary completion in Aug 2021, 67 months.
Results were first posted in Aug 2026, 4 years 11 months after primary completion.
Of 33 non-industry phase 3 interventional studies under Tuberculosis, half reached primary completion within 54 months of starting (the median), counting those still running; a quarter within 38 and three quarters within 67. This study's 67 months is above that.
Counting every sponsor, half of 40 studies reached it within 55 months; a quarter within 38 and three quarters within 76.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.
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Studies of the drugs tested here: Rifapentine · Moxifloxacin · Ethambutol
Centers for Disease Control and Prevention →