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CompletedNCT04525235PHENORIFUpdated Aug 17, 2021

Phenotyping of High Dose Rifampicin

A Phase 1 interventional study of phenotyping cocktail and rifampicin in Tuberculosis, sponsored by Radboud University Medical Center. Completed at 2 sites in South Africa. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2021-08-17.

Sponsored by Radboud University Medical Center · Phase 1, Interventional, and Other

Phase
Phase 1
Study type
Interventional
Enrollment
25
Allocation
Non-randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

Higher doses of rifampicin as a means of more efficient use of this pivotal TB drug has shown promising results and might become standard in future. This means that higher doses of rifampicin will be co-administered with many other drugs taken by TB patients, including anti-retroviral, anti-diabetic, cardiovascular and other drugs. Therefore, in this study the aim is to quantitatively assess the drug interaction potential of high dose rifampicin (\~40 mg/kg daily dose, the currently available maximum tolerated dose) with respect to five major human drug-metabolizing CYP enzymes and P-gp in comparison to the conventional dose of 10 mg/kg daily in pulmonary TB patients. A phenotyping approach with single administration of several selective substrates for multiple enzymes will be used, in order to prevent multiple drug-drug interaction studies.

02

Conditions studied

  • Tuberculosis

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03

In context

Tuberculosis

1,417 studies on the registry are indexed under Tuberculosis; 208 are open to participants now.

This study's enrollment of 25 is below the median of 150 across 952 interventional studies indexed under Tuberculosis.

Browse Tuberculosis studies →

Lead sponsor

Radboud University Medical Center is the lead sponsor of 959 studies on the registry; 134 are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • The participant is able and willing to provide written, informed consent prior to all trial-related procedures.
  • The participant is aged between 18 and 65 years, inclusive.
  • The participant is a diagnosed pulmonary TB patient.
  • The participant is currently being treated with a daily dose of 10 mg/kg rifampicin, i.e. 450 mg daily for patients with a body weight below 55 kg and 600 mg daily for participants with a body weight above 55 kg. This is in correspondence with the local South African TB treatment programme. Furthermore, the participant has to be in the continuation phase of the treatment regimen (i.e. month 3 to 6), has demonstrated reasonable treatment compliance (≥80% of doses) and tolerates treatment well.
  • The participant has a body weight (in light clothing and with no shoes) between 40 and 85 kg, inclusive.
  • The participant is and stays non-pregnant (based on a negative serum pregnancy test,) and non-lactating (female participants of childbearing potential only).

Exclusion criteria

Exclusion Criteria:

  • The patient is in poor general condition where any change in treatment cannot be accepted per discretion of the Investigator.
  • The participant has active Hepatitis B.
  • The participant has active Hepatitis C.
  • The participant is receiving antiretroviral therapy (ART).
  • There is evidence showing the participant has clinically significant metabolic, gastrointestinal, or other abnormalities than could possibly alter the PK of rifampicin and/or the probe drugs.
  • The participant has a history of or current clinically relevant cardiovascular disorder such as:
  • heart failure, atrioventricular (AV) block, arrhythmia, tachyarrhythmia or status after myocardial infarction.
  • family history of sudden death of unknown or cardiac-related cause, or of prolonged QTc interval.
  • The participant has clinically relevant abnormalities in the ECG such as atrioventricular (AV) block, prolongation of the QRS complex over 100 milliseconds, or of a QTc interval over 450 milliseconds on the screening ECG.
  • The participant has abnormal alanine aminotransferase (ALT) and/or aspartate transferase (AST) levels > 3 times the upper limit of the laboratory reference range at screening.
  • The participant has a known or suspected, current drug or amphetamine abuse, that is, in the opinion of the Investigator, sufficient to compromise the safety or cooperation of the patient.
  • The participant used any drugs or substances known to be strong inhibitors or inducers of cytochrome P450 enzymes and/or P-glycoprotein (P-gp) within 2 weeks prior to day 1 (i.e. 1 month before administration of the phenotyping probes on day 15) of the study (including carbamazepine, barbiturates, St. John's Wort, clarithromycin, itraconazole, fluconazole, quinidine, ketoconazole, erythromycin). Exceptions may be made for participants who have received 3 days or less of one of these drugs or substances, if there has been a wash-out period equivalent to at least 5 half-lives of that drug or substance before day 1 of the study.
  • The participant uses any of the phenotyping probe drugs (i.e. midazolam, caffeine, dextromethorphan, tolbutamide, omeprazole and digoxin) as part of standard medical treatment.
  • The participant has as history of allergy to any of the phenotyping probe drugs (i.e. midazolam, caffeine, dextromethorphan, tolbutamide, omeprazole and digoxin).
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Study design

Phase
Phase 1
Primary purpose
Other
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
25 participants (actual)

Study arms

  • Active comparator
    Rifampicin standard dose

    rifampicin standard dose + phenotyping cocktail

    Combination Product: phenotyping cocktail · Drug: rifampicin

  • Experimental
    Rifampicin high dose

    rifampicin high dose + phenotyping cocktail

    Combination Product: phenotyping cocktail · Drug: rifampicin

Interventions

  • Combination productphenotyping cocktail

    A single dose of a cocktail of phenotyping probe drugs (caffeine, tolbutamide, omeprazole, dextromethorphan, midazolam and digoxin) will be administered together with standard dose rifampicin and 40 mg/kg rifampicin, respectively. Blood samples will be taken to assess phenotyping metrics of the cocktail agents and rifampicin pharmacokinetic parameters. The effect of high and standard dose rifampicin on the phenotyping metrics of the cocktail agents will be compared by using the bioequivalence approach

    Also known as: digoxin, caffeine, tolbutamide, midazolam, dextromethorphan, omeprazole

  • Drugrifampicin

    A single dose of a cocktail of phenotyping probe drugs (caffeine, tolbutamide, omeprazole, dextromethorphan, midazolam and digoxin) will be administered together with standard dose rifampicin and 40 mg/kg rifampicin, respectively. Blood samples will be taken to assess phenotyping metrics of the cocktail agents and rifampicin pharmacokinetic parameters. The effect of high and standard dose rifampicin on the phenotyping metrics of the cocktail agents will be compared by using the bioequivalence approach

06

What researchers measure

Primary outcomes

  1. area under the curve

    area under the curve of probe drugs

    Time frame: 24 hours

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Study locations

2 sites
  • TASK
    Cape Town, South Africa
  • UCT lung institute
    Cape Town, South Africa
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 17, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04525235
Lead sponsor
Radboud University Medical Center
Responsible party
Sponsor
First posted
Aug 25, 2020
Start date
Jan 7, 2021
Primary completion
Aug 12, 2021
Completion
Aug 12, 2021
Last update
Aug 17, 2021

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Aug 2021. You cannot join it, but the record below documents what was studied.

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