ClinicalTrials.gg
CompletedNCT05007821Updated Oct 2, 2026Results posted

Linezolid Dosing Strategies in Drug-Resistant TB

A Phase 2 interventional study of Linezolid 600 mg and Linezolid 1200 mg (QD) in Tuberculosis, Multidrug-Resistant, Tuberculosis and Tuberculosis, Pulmonary, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 13 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-02.

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Phase 2, Interventional, and Treatment

Updated Oct 2, 2026Posted results revisedGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
138
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of the study was to evaluate the efficacy (how well the medicines work) and tolerability (whether participants stop treatment because of side effects from a drug) of an anti-TB treatment regimen that compared two doses of linezolid (LZD), combined with bedaquiline (BDQ), delamanid (DLM), and clofazimine (CFZ). This study also measured the level of LZD and BDQ in the participants' blood.

Read the detailed description

When the study was designed, there was currently no "standard of care" or single standardized treatment regimen recommended for everyone with drug resistant-tuberculosis (DR-TB). Current DR-TB treatments were not well tolerated and often had side effects. There was a need to identify drugs with enough anti-TB activity (treatment against TB) and good safety profiles that could improve outcomes in the treatment of DR-TB.

The main purpose of this study was to evaluate the efficacy and tolerability of a new shorter course anti-TB treatment regimen that compared two dosing strategies of linezolid (LZD), combined with bedaquiline (BDQ), delamanid (DLM), and clofazimine (CFZ). As a secondary aim, the study assessed the safety (the level and type of side effects from a drug or treatment) of the combination of these drugs.

Everyone in the study took BDQ, DLM, and CFZ once a day for the entire treatment period. The difference between the two treatment groups in the study was in how participants took the fourth drug: LZD. Participants in group A took one dose of LZD once a day for the entire treatment period. Participants in group B took a higher dose of LZD once a day for 4 weeks and then took that higher dose of LZD just three times a week for the rest of the treatment period.

02

Conditions studied

  • Tuberculosis, Multidrug-Resistant
  • Tuberculosis
  • Tuberculosis, Pulmonary
03

In context

Tuberculosis, Multidrug-Resistant

132 studies on the registry are indexed under Tuberculosis, Multidrug-Resistant; 25 are open to participants now.

This study's enrollment of 138 is below the median of 194 across 88 interventional studies indexed under Tuberculosis, Multidrug-Resistant.

Browse Tuberculosis, Multidrug-Resistant studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,446 studies on the registry; 179 are open to participants now.

Of its 405 completed or terminated interventional studies of FDA-regulated products, 302 (75%) have results posted.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Newly diagnosed pulmonary drug-resistant tuberculosis (DR-TB), with resistance to at least rifampicin or rifampin (which is a drug used in the therapy of tuberculosis) confirmed from a sputum specimen collected within 60 days prior to entry.
  2. -1 infection status documented as either absent or present.
  3. For participants living with HIV, either currently on an antiretroviral therapy (ART) regimen or willing and able to start ART within 30 days after entry.
  4. Efavirenz or etravirine (drugs used to treat HIV) must be discontinued prior to a participant's starting anti-TB medications. For participants on efavirenz or etravirine, they must be willing and able to discontinue these at least 7 days prior to initiating study TB medications.
  5. For participants living with HIV, CD4+ cell (a type of white blood cell) count greater than or equal to 50 cells/mm3 obtained within 60 days prior to study entry.
  6. For females of , negative serum or urine pregnancy test.
  7. Females of reproductive potential who are participating in sexual activity that could lead to pregnancy must agree to use two of the following forms of while receiving TB study medications and for 30 days after stopping study medications:

    • Male or female condoms
    • Diaphragm or cervical cap (with spermicide, if available)
    • Intrauterine device (IUD) or intrauterine system (IUS)
    • Hormone-based birth control (e.g., oral contraceptives, Depo-Provera, NuvaRing, implants)
  8. Appropriate laboratory values as determined by the study doctor obtained within 14 days prior to entry.
  9. performance score (an assessment tool for functional impairment) greater than or equal to 50 within 30 days prior to entry.
  10. Ability and willingness of candidate and/or legal guardian/representative to provide and meet requirements for the study.
  11. Chest X-ray obtained within 30 days prior to entry.

Exclusion criteria

Exclusion Criteria:

  1. Documentation of (as judged by the study doctor) active infections (including -related opportunistic infections) other than TB and HIV requiring treatment within 30 days prior to entry.
  2. Evidence of clinically significant (as judged by the study doctor) metabolic, gastrointestinal, cardiovascular, musculoskeletal, ophthalmological, pulmonary, neurological, psychiatric, endocrine diseases, , or other abnormalities (other than the indication being studied) that would interfere with study medications or procedures.
  3. Inability to take oral medications.
  4. Suspected or documented TB involving the central nervous system, clinically significant renal TB or TB pericarditis, or current extrapulmonary TB involving other organ systems that might interfere with study medications or procedures, as judged by the study doctor.
  5. Prior treatment with one or more of the study drugs at any time in the past for an episode of DR-TB that is not the qualifying episode or treatment for more than 7 cumulative days with one or more of the study drugs within 30 days prior to entry for the qualifying episode of DR-TB.
  6. History of allergy or to any of the study drugs or medications in the same class as the study drugs.
  7. Known or suspected current alcohol and/or drug abuse that is, in the opinion of the study doctor, sufficient to compromise the safety and/or cooperation of the participant.
  8. Receipt of any drugs within 60 days prior to entry.
  9. Known history of prolonged syndrome (heart rhythm condition that can potentially cause fast, chaotic heartbeats) or current prolonged QT interval on screening (a medical test that detects cardiac (heart) abnormalities).
  10. Known history of clinically significant cardiac arrhythmia (a condition in which the heart beats with an irregular or abnormal rhythm) requiring medication or clinically significant electrocardiogram (ECG) abnormality, in the opinion of the study doctor, within 60 days prior to entry.
  11. Pregnancy or current breastfeeding, or intent to become pregnant and/or breastfeed while on study treatment.
  12. Current use of monoamine oxidase inhibitors (type of medication used to treat depression) or use within 30 days prior to entry.
  13. Current use of serotonergic agents including SSRI/SNRI antidepressants or prior use within 30 days prior to entry.
  14. Known history of optic neuropathy (damage to the optic nerve in your eye) of any grade as diagnosed by an ophthalmologist.
  15. Current peripheral neuropathy (when nerves are damaged or destroyed and can't send messages from the brain and spinal cord to the muscles, skin and other parts of the body) with severe paresthesias ("pins and needles") and/or mild weakness or worse (Grade ≥2.).
  16. Weight less than 35 kg (77 lbs).
  17. Currently taking other prohibited medications.
Terms in these criteria, in plain language(11)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
138 participants (actual)

Study arms

  • Experimental
    Arm A

    Everyone in the study took bedaquiline (BDQ), delamanid (DLM), and clofazimine (CFZ) once a day for the entire treatment period. Arm A participants took linezolid (LZD) once a day for the entire treatment period. * Weeks 1-26: LZD 600 mg once daily (QD) * Weeks 1-2: BDQ 200 mg QD + DLM 300 mg QD + CFZ 300 mg QD * Weeks 3-8: BDQ 200 mg QD + DLM 300 mg QD + CFZ 100 mg QD * Weeks 9-26: BDQ 100 mg QD + DLM 300 mg QD + CFZ 100 mg QD

    Drug: Linezolid 600 mg · Drug: Bedaquiline 200 mg · Drug: Bedaquiline 100 mg · Drug: Delamanid 300 mg · Drug: Clofazimine 300 mg · Drug: Clofazimine 100 mg

  • Experimental
    Arm B

    Everyone in the study took bedaquiline (BDQ), delamanid (DLM), and clofazimine (CFZ) once a day for the entire treatment period. Arm B participants took a higher dose of linezolid (LZD) once a day for 4 weeks and then took that higher dose of LZD just three times a week for the rest of the treatment period. * Weeks 1-4: LZD 1200 mg once daily (QD) * Weeks 5-26: LZD 1200 mg three times per week (TIW) * Weeks 1-2: BDQ 200 mg QD + DLM 300 mg QD + CFZ 300 mg QD * Weeks 3-8: BDQ 200 mg QD + DLM 300 mg QD + CFZ 100 mg QD * Weeks 9-26: BDQ 100 mg QD + DLM 300 mg QD + CFZ 100 mg QD

    Drug: Linezolid 1200 mg (QD) · Drug: Linezolid 1200 mg (TIW) · Drug: Bedaquiline 200 mg · Drug: Bedaquiline 100 mg · Drug: Delamanid 300 mg · Drug: Clofazimine 300 mg · Drug: Clofazimine 100 mg

Interventions

  • One 600mg tablet taken orally once daily (QD) in the morning during weeks 1-26

    Also known as: LZD

  • Two 600mg tablets taken orally once daily (QD) in the morning during weeks 1-4

    Also known as: LZD

  • Two 600mg tablets taken orally three times per week (TIW; Mon-Wed-Fri) in the morning during weeks 5-26

    Also known as: LZD

  • Two 100mg tablets taken orally once daily in the morning during weeks 1-8

    Also known as: BDQ

  • One 100mg tablet taken orally once daily in the morning during weeks 9-26

    Also known as: BDQ

  • Six 50mg tablets taken orally once daily in the morning during weeks 1-26

    Also known as: DLM

  • Three 100mg capsules taken orally once daily in the morning during weeks 1-2

    Also known as: CFZ

  • One 100mg capsule taken orally once daily in the morning during weeks 3-26

    Also known as: CFZ

06

What researchers measure

Primary outcomes

  1. Time to 26 Weeks Stable Culture Conversion in Liquid Media

    Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If the 1st MTB-neg liquid culture was at week 26, then conversion was met. If a participant did not convert by week 26, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 26 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions at week 26 and the Cox proportional hazards regression model hazard ratio were calculated; between-arm differences were tested with the log rank test.

    Time frame: Up to 26 weeks

  2. Proportion of Participants With Permanent Discontinuation of At Least One Anti-TB Drug Due To Adverse Events, Intolerance, Or Death

    Time of permanent discontinuation of at least one anti-TB drug due to side effects that did not lead to a protocol-required discontinuation, due to participant non-compliance with at least one anti-TB drug or study visits, or due to participant request was the corresponding date of discontinuation. If a participant did not permanently discontinue at least one anti-TB drug due to side effects that did not lead to a protocol-required discontinuation, due to participant non-compliance with at least one anti-TB drug or study visits, or due to participant request by week 26, they were censored at the date of permanent treatment discontinuation of all study drugs or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with permanent discontinuation were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: Up to 26 weeks

Secondary outcomes

  1. Proportion of Participants Achieving Stable Liquid Culture Conversion

    Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If a participant did not convert by week 8, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 8 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions of participants with stable liquid culture conversion were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: At week 8

  2. Proportion of Participants Achieving Stable Liquid Culture Conversion

    Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If a participant did not convert by week 16, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 16 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions of participants with stable liquid culture conversion were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: At week 16

  3. Proportion of Participants Achieving Stable Liquid Culture Conversion

    Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If a participant did not convert by week 26, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 26 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions of participants with stable liquid culture conversion were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: At week 26

  4. Proportion of Participants Achieving Stable Liquid Culture Conversion

    Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If a participant did not convert by week 38, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 38 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions of participants with stable liquid culture conversion were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: At week 38

  5. Proportion of Participants With Permanent Discontinuation of LZD Due To Adverse Events, Intolerance, or Death

    Time of permanent discontinuation of LZD due to side effects that did not lead to a protocol-required discontinuation, due to participant non-compliance with LZD or study visits, or due to participant request was the corresponding date of discontinuation. If a participant did not permanently discontinue LZD due to side effects that did not lead to a protocol-required discontinuation, due to participant non-compliance with LZD or study visits, or due to participant request by week 26, they were censored at the date of permanent discontinuation of LZD or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with permanent discontinuation were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: Up to 26 weeks

  6. Proportion of Participants With Temporary Discontinuation of LZD For Any Reason

    Time of temporary discontinuation of LZD for any reason was the corresponding date of first temporary discontinuation. If a participant did not temporarily discontinue LZD by week 26, they were censored at the date of permanent discontinuation of LZD or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with temporary discontinuation of LZD were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: Up to 26 weeks

  7. Proportion of Participants With LZD Dose Reduction

    Time of LZD dose reduction was the corresponding date of the first LZD dose reduction. If a participant did not undergo a LZD dose reduction by week 26, they were censored at the date of permanent discontinuation of LZD or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with LZD dose reduction were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: Up to 26 weeks

  8. Proportion of Participants With Treatment-Related Adverse Events

    Time of treatment-related adverse event was the corresponding date of the adverse event. If a participant did not experience a treatment-related adverse event, they were censored at the date of permanent treatment discontinuation of all study drugs or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with treatment-related adverse event were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: Up to 26 weeks

  9. Proportion of Participants With Unfavorable TB Treatment Outcome

    Unfavorable TB treatment outcome is defined as meeting one or more of the following: 1. Participants with confirmed microbiologic TB treatment failure; 2. Participants who fail to complete study treatment or require extension of study treatment beyond the study-prescribed treatment duration due to clinically inadequate response; 3. Participants who had a positive sputum MTB culture at their last study visit; 4. Participants who die from any cause during study treatment, except from violent or accidental cause; or 5. Participants failing to complete study treatment and not assessable at the end of the follow-up period. If a participant did not experience an unfavorable TB treatment outcome by week 26, they were censored at their last TB treatment outcome determination. Within-arm Kaplan-Meier estimates of proportions of participants with unfavorable TB treatment outcome were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: At week 26

  10. Proportion of Participants With Unfavorable TB Treatment Outcome

    Unfavorable TB treatment outcome is defined as meeting one or more of the following: 1. Participants with confirmed microbiologic TB treatment failure; 2. Participants who fail to complete study treatment or require extension of study treatment beyond the study-prescribed treatment duration due to clinically inadequate response; 3. Participants who had a positive sputum MTB culture at their last study visit; 4. Participants who die from any cause during study treatment, except from violent or accidental cause; or 5. Participants failing to complete study treatment and not assessable at the end of the follow-up period. If a participant did not experience an unfavorable TB treatment outcome by week 38, they were censored at their last TB treatment outcome determination. Within-arm Kaplan-Meier estimates of proportions of participants with unfavorable TB treatment outcome were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: At week 38

  11. Proportion of Participants With Unfavorable TB Treatment Outcome

    Unfavorable TB treatment outcome is defined as meeting one or more of the following: 1. Participants with confirmed microbiologic TB treatment failure; 2. Participants who fail to complete study treatment or require extension of study treatment beyond the study-prescribed treatment duration due to clinically inadequate response; 3. Participants who had a positive sputum MTB culture at their last study visit; 4. Participants who die from any cause during study treatment, except from violent or accidental cause; or 5. Participants failing to complete study treatment and not assessable at the end of the follow-up period. If a participant did not experience an unfavorable TB treatment outcome by week 72, they were censored at their last TB treatment outcome determination. Within-arm Kaplan-Meier estimates of proportions of participants with unfavorable TB treatment outcome were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

    Time frame: At week 72

  12. Pharmacokinetic Parameter for Linezolid: Minimum Plasma Concentration (Cmin)

    Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

    Time frame: At week 4

  13. Pharmacokinetic Parameter for Linezolid: Maximum Plasma Concentration (Cmax)

    Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

    Time frame: At week 4

  14. Pharmacokinetic Parameter for Linezolid: Time to Reach Maximum Plasma Concentration (Tmax)

    Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

    Time frame: At week 4

  15. Pharmacokinetic Parameter for Linezolid: Area Under the Concentration-time Curve (AUC)

    Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA). AUC24h (area under the curve from 0 to 24 hours) were determined using the linear-log trapezoidal rule.

    Time frame: At week 4

  16. Pharmacokinetic Parameter for Linezolid: Apparent Oral Clearance (CL/F)

    Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA).

    Time frame: At week 4

  17. Pharmacokinetic Parameter for Delamanid: Minimum Plasma Concentration (Cmin)

    Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

    Time frame: At week 4

  18. Pharmacokinetic Parameter for Delamanid: Maximum Plasma Concentration (Cmax)

    Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

    Time frame: At week 4

  19. Pharmacokinetic Parameter for Delamanid: Time to Reach Maximum Plasma Concentration (Tmax)

    Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

    Time frame: At week 4

  20. Pharmacokinetic Parameter for Delamanid: Area Under the Concentration-time Curve (AUC)

    Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA). AUC24h (area under the curve from 0 to 24 hours) were determined using the linear-log trapezoidal rule.

    Time frame: At week 4

  21. Pharmacokinetic Parameter for Delamanid: Apparent Oral Clearance (CL/F)

    Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA).

    Time frame: At week 4

  22. Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Minimum Plasma Concentration (Cmin)

    Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

    Time frame: At week 4

  23. Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Maximum Plasma Concentration (Cmax)

    Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

    Time frame: At week 4

  24. Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Time to Reach Maximum Plasma Concentration (Tmax)

    Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

    Time frame: At week 4

  25. Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Area Under the Concentration-time Curve (AUC)

    Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA). AUC24h (area under the curve from 0 to 24 hours) were determined using the linear-log trapezoidal rule.

    Time frame: At week 4

  26. Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Apparent Oral Clearance (CL/F)

    Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA).

    Time frame: At week 4

  27. Number of Participants With >90% Directly Observed Therapy Doses Taken During the Treatment Period

    At each visit, the site reported the number of directly observed therapy (DOT) doses since the last visit. The number of expected DOT doses was 182. The number of expected DOT doses was adjusted by removing the number of days during temporary holds due to adverse events. This avoided penalizing participants who missed DOT doses due to protocol-required treatment holds for adverse events. Participants who missed DOT doses for other reasons were penalized even if they made up the missed doses by the week 30 study visit as allowed by the protocol. The proportion of expected 182 DOT doses was calculated as the total number of DOT doses reported by the site divided by the adjusted number of expected DOT doses.

    Time frame: Up to 26 weeks

07

Results

Posted May 1, 2026

Participant flow

Participants were enrolled from 27 September 2022 to 04 September 2024 in 13 sites located in South Africa (5 sites), Haiti (2 sites), Thailand (2 sites), Botswana, Brazil, Peru, and Philippines.

Participant flow — Overall Study
MilestoneArm AArm B
Started6969
Completed6059
Not completed910
Withdrew: Death04
Withdrew: Lost to follow-up64
Withdrew: Protocol violation22
Withdrew: Withdrawal by subject10

Outcome measures

PrimaryTime to 26 Weeks Stable Culture Conversion in Liquid Media

Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If the 1st MTB-neg liquid culture was at week 26, then conversion was met. If a participant did not convert by week 26, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 26 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions at week 26 and the Cox proportional hazards regression model hazard ratio were calculated; between-arm differences were tested with the log rank test.

Time frame:
Up to 26 weeks
Reported as:
Median · Weeks
Time to 26 Weeks Stable Culture Conversion in Liquid Media
WeeksArm AArm B
Time to 26 Weeks Stable Culture Conversion in Liquid Media8 (6 to 12)12 (6 to 16)
Statistical analysis
  • Arm A vs Arm B · Log Rank · p = 0.0333 · Hazard ratio (hr): 0.74 · 95% CI 0.51 to 1.08No adjustments performed
  • Arm A vs Arm B · Regression, Cox · p = 0.64A Cox Proportional Hazards regression model was used to test whether there was a statistically significant interaction between treatment and sex.
  • Arm A vs Arm B · Regression, Cox · p = 0.33A Cox Proportional Hazards regression model was used to test whether there was a statistically significant interaction between treatment and race.
PrimaryProportion of Participants With Permanent Discontinuation of At Least One Anti-TB Drug Due To Adverse Events, Intolerance, Or Death

Time of permanent discontinuation of at least one anti-TB drug due to side effects that did not lead to a protocol-required discontinuation, due to participant non-compliance with at least one anti-TB drug or study visits, or due to participant request was the corresponding date of discontinuation. If a participant did not permanently discontinue at least one anti-TB drug due to side effects that did not lead to a protocol-required discontinuation, due to participant non-compliance with at least one anti-TB drug or study visits, or due to participant request by week 26, they were censored at the date of permanent treatment discontinuation of all study drugs or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with permanent discontinuation were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
Up to 26 weeks
Reported as:
Number · proportion of participants
Proportion of Participants With Permanent Discontinuation of At Least One Anti-TB Drug Due To Adverse Events, Intolerance, Or Death
proportion of participantsArm AArm B
Proportion of Participants With Permanent Discontinuation of At Least One Anti-TB Drug Due To Adverse Events, Intolerance, Or Death0.153 (0.086 to 0.266)0.152 (0.085 to 0.264)
Statistical analysis
  • Arm A vs Arm B · Z-test, other · p = 0.98 · Risk difference (rd): -0.002 · 95% CI -0.12 to 0.12Difference in cumulative proportion (Arm B - Arm A).
  • Arm A vs Arm B · Regression, Cox · p = 0.25A Cox Proportional Hazards regression model was used to test whether there was a statistically significant interaction between treatment and sex.
  • Arm A vs Arm B · Regression, Cox · p = 0.83A Cox Proportional Hazards regression model was used to test whether there was a statistically significant interaction between treatment and race.
SecondaryProportion of Participants Achieving Stable Liquid Culture Conversion

Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If a participant did not convert by week 8, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 8 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions of participants with stable liquid culture conversion were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
At week 8
Reported as:
Number · proportion of participants
Proportion of Participants Achieving Stable Liquid Culture Conversion
proportion of participantsArm AArm B
Proportion of Participants Achieving Stable Liquid Culture Conversion0.607 (0.487 to 0.728)0.488 (0.365 to 0.626)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.20 · Risk difference (rd): -0.119 · 95% CI -0.299 to 0.061Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants Achieving Stable Liquid Culture Conversion

Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If a participant did not convert by week 16, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 16 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions of participants with stable liquid culture conversion were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
At week 16
Reported as:
Number · proportion of participants
Proportion of Participants Achieving Stable Liquid Culture Conversion
proportion of participantsArm AArm B
Proportion of Participants Achieving Stable Liquid Culture Conversion0.962 (0.886 to 0.993)0.903 (0.807 to 0.964)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.22 · Risk difference (rd): -0.058 · 95% CI -0.153 to 0.036Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants Achieving Stable Liquid Culture Conversion

Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If a participant did not convert by week 26, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 26 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions of participants with stable liquid culture conversion were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
At week 26
Reported as:
Number · proportion of participants
Proportion of Participants Achieving Stable Liquid Culture Conversion
proportion of participantsArm AArm B
Proportion of Participants Achieving Stable Liquid Culture Conversion0.967 (0.899 to 0.994)0.917 (0.823 to 0.972)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.25 · Risk difference (rd): -0.05 · 95% CI -0.14 to 0.04Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants Achieving Stable Liquid Culture Conversion

Time of stable liquid culture conversion was the visit corresponding to the 1st of 2 consecutive MTB-neg cultures obtained at least 7 days apart without an intervening MTB-pos culture. Inability to produce sputum with or without induction was considered an MTB-neg culture. A participant was MTB-pos at a visit if at least 1 of the liquid cultures was MTB-pos. A participant was MTB-neg at a visit if both liquid cultures were MTB-neg or if 1 liquid culture was MTB-neg and the other was missing or indeterminate. If a participant did not convert by week 38, they were censored at their last culture result. If a participant died (any cause except trauma), they were censored at week 38 (worst possible outcome). Within-arm Kaplan-Meier estimates of proportions of participants with stable liquid culture conversion were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
At week 38
Reported as:
Number · proportion of participants
Proportion of Participants Achieving Stable Liquid Culture Conversion
proportion of participantsArm AArm B
Proportion of Participants Achieving Stable Liquid Culture Conversion0.934 (0.854 to 0.979)0.946 (0.866 to 0.986)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided] · p = 0.78 · Risk difference (rd): 0.012 · 95% CI -0.074 to 0.098Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants With Permanent Discontinuation of LZD Due To Adverse Events, Intolerance, or Death

Time of permanent discontinuation of LZD due to side effects that did not lead to a protocol-required discontinuation, due to participant non-compliance with LZD or study visits, or due to participant request was the corresponding date of discontinuation. If a participant did not permanently discontinue LZD due to side effects that did not lead to a protocol-required discontinuation, due to participant non-compliance with LZD or study visits, or due to participant request by week 26, they were censored at the date of permanent discontinuation of LZD or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with permanent discontinuation were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
Up to 26 weeks
Reported as:
Number · proportion of participants
Proportion of Participants With Permanent Discontinuation of LZD Due To Adverse Events, Intolerance, or Death
proportion of participantsArm AArm B
Proportion of Participants With Permanent Discontinuation of LZD Due To Adverse Events, Intolerance, or Death0.108 (0.053 to 0.213)0.136 (0.073 to 0.245)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.62 · Risk difference (rd): 0.028 · 95% CI -0.08 to 0.14Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants With Temporary Discontinuation of LZD For Any Reason

Time of temporary discontinuation of LZD for any reason was the corresponding date of first temporary discontinuation. If a participant did not temporarily discontinue LZD by week 26, they were censored at the date of permanent discontinuation of LZD or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with temporary discontinuation of LZD were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
Up to 26 weeks
Reported as:
Number · proportion of participants
Proportion of Participants With Temporary Discontinuation of LZD For Any Reason
proportion of participantsArm AArm B
Proportion of Participants With Temporary Discontinuation of LZD For Any Reason0.32 (0.22 to 0.45)0.29 (0.20 to 0.42)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.70 · Risk difference (rd): -0.03 · 95% CI -0.19 to 0.13Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants With LZD Dose Reduction

Time of LZD dose reduction was the corresponding date of the first LZD dose reduction. If a participant did not undergo a LZD dose reduction by week 26, they were censored at the date of permanent discontinuation of LZD or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with LZD dose reduction were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
Up to 26 weeks
Reported as:
Number · proportion of participants
Proportion of Participants With LZD Dose Reduction
proportion of participantsArm AArm B
Proportion of Participants With LZD Dose Reduction0.28 (0.19 to 0.41)0.30 (0.21 to 0.43)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.76 · Risk difference (rd): 0.02 · 95% CI -0.13 to 0.18Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants With Treatment-Related Adverse Events

Time of treatment-related adverse event was the corresponding date of the adverse event. If a participant did not experience a treatment-related adverse event, they were censored at the date of permanent treatment discontinuation of all study drugs or, if still on study treatment, at week 26. Within-arm Kaplan-Meier estimates of proportions of participants with treatment-related adverse event were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
Up to 26 weeks
Reported as:
Number · proportion of participants
Proportion of Participants With Treatment-Related Adverse Events
proportion of participantsArm AArm B
Proportion of Participants With Treatment-Related Adverse Events0.68 (0.56 to 0.78)0.68 (0.57 to 0.79)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.91 · Risk difference (rd): 0.01 · 95% CI -0.15 to 0.17Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants With Unfavorable TB Treatment Outcome

Unfavorable TB treatment outcome is defined as meeting one or more of the following: 1. Participants with confirmed microbiologic TB treatment failure; 2. Participants who fail to complete study treatment or require extension of study treatment beyond the study-prescribed treatment duration due to clinically inadequate response; 3. Participants who had a positive sputum MTB culture at their last study visit; 4. Participants who die from any cause during study treatment, except from violent or accidental cause; or 5. Participants failing to complete study treatment and not assessable at the end of the follow-up period. If a participant did not experience an unfavorable TB treatment outcome by week 26, they were censored at their last TB treatment outcome determination. Within-arm Kaplan-Meier estimates of proportions of participants with unfavorable TB treatment outcome were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
At week 26
Reported as:
Number · proportion of participants
Proportion of Participants With Unfavorable TB Treatment Outcome
proportion of participantsArm AArm B
Proportion of Participants With Unfavorable TB Treatment Outcome0.10 (0.04 to 0.20)0.16 (0.08 to 0.28)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.32 · Risk difference (rd): 0.06 · 95% CI -0.06 to 0.18Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants With Unfavorable TB Treatment Outcome

Unfavorable TB treatment outcome is defined as meeting one or more of the following: 1. Participants with confirmed microbiologic TB treatment failure; 2. Participants who fail to complete study treatment or require extension of study treatment beyond the study-prescribed treatment duration due to clinically inadequate response; 3. Participants who had a positive sputum MTB culture at their last study visit; 4. Participants who die from any cause during study treatment, except from violent or accidental cause; or 5. Participants failing to complete study treatment and not assessable at the end of the follow-up period. If a participant did not experience an unfavorable TB treatment outcome by week 38, they were censored at their last TB treatment outcome determination. Within-arm Kaplan-Meier estimates of proportions of participants with unfavorable TB treatment outcome were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
At week 38
Reported as:
Number · proportion of participants
Proportion of Participants With Unfavorable TB Treatment Outcome
proportion of participantsArm AArm B
Proportion of Participants With Unfavorable TB Treatment Outcome0.15 (0.08 to 0.28)0.22 (0.12 to 0.37)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.40 · Risk difference (rd): 0.07 · 95% CI -0.09 to 0.22Difference in cumulative proportion (Arm B - Arm A).
SecondaryProportion of Participants With Unfavorable TB Treatment Outcome

Unfavorable TB treatment outcome is defined as meeting one or more of the following: 1. Participants with confirmed microbiologic TB treatment failure; 2. Participants who fail to complete study treatment or require extension of study treatment beyond the study-prescribed treatment duration due to clinically inadequate response; 3. Participants who had a positive sputum MTB culture at their last study visit; 4. Participants who die from any cause during study treatment, except from violent or accidental cause; or 5. Participants failing to complete study treatment and not assessable at the end of the follow-up period. If a participant did not experience an unfavorable TB treatment outcome by week 72, they were censored at their last TB treatment outcome determination. Within-arm Kaplan-Meier estimates of proportions of participants with unfavorable TB treatment outcome were calculated with 2-sided 95% confidence intervals using standard errors based on Greenwood's formula.

Time frame:
At week 72
Reported as:
Number · proportion of participants
Proportion of Participants With Unfavorable TB Treatment Outcome
proportion of participantsArm AArm B
Proportion of Participants With Unfavorable TB Treatment Outcome0.13 (0.07 to 0.24)0.20 (0.12 to 0.33)
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.29 · Risk difference (rd): 0.07 · 95% CI -0.06 to 0.21Difference in cumulative proportion (Arm B - Arm A).
SecondaryPharmacokinetic Parameter for Linezolid: Minimum Plasma Concentration (Cmin)

Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

Time frame:
At week 4
Reported as:
Median · ng/mL
Pharmacokinetic Parameter for Linezolid: Minimum Plasma Concentration (Cmin)
ng/mLArm AArm B
Pharmacokinetic Parameter for Linezolid: Minimum Plasma Concentration (Cmin)1855 (1104 to 2365)4170 (3070 to 8360)
SecondaryPharmacokinetic Parameter for Linezolid: Maximum Plasma Concentration (Cmax)

Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

Time frame:
At week 4
Reported as:
Median · ng/mL
Pharmacokinetic Parameter for Linezolid: Maximum Plasma Concentration (Cmax)
ng/mLArm AArm B
Pharmacokinetic Parameter for Linezolid: Maximum Plasma Concentration (Cmax)14200 (11500 to 17100)31550 (26650 to 36350)
SecondaryPharmacokinetic Parameter for Linezolid: Time to Reach Maximum Plasma Concentration (Tmax)

Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

Time frame:
At week 4
Reported as:
Median · hours
Pharmacokinetic Parameter for Linezolid: Time to Reach Maximum Plasma Concentration (Tmax)
hoursArm AArm B
Pharmacokinetic Parameter for Linezolid: Time to Reach Maximum Plasma Concentration (Tmax)4 (2 to 4.01)2.93 (1.5 to 4)
SecondaryPharmacokinetic Parameter for Linezolid: Area Under the Concentration-time Curve (AUC)

Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA). AUC24h (area under the curve from 0 to 24 hours) were determined using the linear-log trapezoidal rule.

Time frame:
At week 4
Reported as:
Median · hours*ng/mL
Pharmacokinetic Parameter for Linezolid: Area Under the Concentration-time Curve (AUC)
hours*ng/mLArm AArm B
Pharmacokinetic Parameter for Linezolid: Area Under the Concentration-time Curve (AUC)167028 (128180 to 187298)370726 (292156 to 460426)
SecondaryPharmacokinetic Parameter for Linezolid: Apparent Oral Clearance (CL/F)

Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA).

Time frame:
At week 4
Reported as:
Median · mL/h
Pharmacokinetic Parameter for Linezolid: Apparent Oral Clearance (CL/F)
mL/hArm AArm B
Pharmacokinetic Parameter for Linezolid: Apparent Oral Clearance (CL/F)3592 (3204 to 4682)3237 (2608 to 4109)
SecondaryPharmacokinetic Parameter for Delamanid: Minimum Plasma Concentration (Cmin)

Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

Time frame:
At week 4
Reported as:
Median · ng/mL
Pharmacokinetic Parameter for Delamanid: Minimum Plasma Concentration (Cmin)
ng/mLArm AArm B
Pharmacokinetic Parameter for Delamanid: Minimum Plasma Concentration (Cmin)201 (137 to 225)140 (97.4 to 202)
SecondaryPharmacokinetic Parameter for Delamanid: Maximum Plasma Concentration (Cmax)

Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

Time frame:
At week 4
Reported as:
Median · ng/mL
Pharmacokinetic Parameter for Delamanid: Maximum Plasma Concentration (Cmax)
ng/mLArm AArm B
Pharmacokinetic Parameter for Delamanid: Maximum Plasma Concentration (Cmax)475 (401 to 502)416 (271 to 494)
SecondaryPharmacokinetic Parameter for Delamanid: Time to Reach Maximum Plasma Concentration (Tmax)

Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

Time frame:
At week 4
Reported as:
Median · hours
Pharmacokinetic Parameter for Delamanid: Time to Reach Maximum Plasma Concentration (Tmax)
hoursArm AArm B
Pharmacokinetic Parameter for Delamanid: Time to Reach Maximum Plasma Concentration (Tmax)4.03 (4 to 8)4 (3 to 4)
SecondaryPharmacokinetic Parameter for Delamanid: Area Under the Concentration-time Curve (AUC)

Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA). AUC24h (area under the curve from 0 to 24 hours) were determined using the linear-log trapezoidal rule.

Time frame:
At week 4
Reported as:
Median · hours*ng/mL
Pharmacokinetic Parameter for Delamanid: Area Under the Concentration-time Curve (AUC)
hours*ng/mLArm AArm B
Pharmacokinetic Parameter for Delamanid: Area Under the Concentration-time Curve (AUC)7263 (6107 to 8295)6204 (4280 to 7643)
SecondaryPharmacokinetic Parameter for Delamanid: Apparent Oral Clearance (CL/F)

Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA).

Time frame:
At week 4
Reported as:
Median · mL/h
Pharmacokinetic Parameter for Delamanid: Apparent Oral Clearance (CL/F)
mL/hArm AArm B
Pharmacokinetic Parameter for Delamanid: Apparent Oral Clearance (CL/F)41314 (36176 to 49135)48611 (39255 to 70088)
SecondaryPharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Minimum Plasma Concentration (Cmin)

Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

Time frame:
At week 4
Reported as:
Median · ng/mL
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Minimum Plasma Concentration (Cmin)
ng/mLArm AArm B
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Minimum Plasma Concentration (Cmin)95 (75.5 to 114)73.8 (56.2 to 117)
SecondaryPharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Maximum Plasma Concentration (Cmax)

Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

Time frame:
At week 4
Reported as:
Median · ng/mL
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Maximum Plasma Concentration (Cmax)
ng/mLArm AArm B
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Maximum Plasma Concentration (Cmax)130 (103 to 161)125 (89.1 to 157)
SecondaryPharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Time to Reach Maximum Plasma Concentration (Tmax)

Estimated based on concentrations from intensive PK sampling times at pre-dose, 1 hour, 2 hours, 4 hours, 8 hours, and 24 hours.

Time frame:
At week 4
Reported as:
Median · hours
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Time to Reach Maximum Plasma Concentration (Tmax)
hoursArm AArm B
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Time to Reach Maximum Plasma Concentration (Tmax)4.06 (3 to 8)7.90 (3 to 8)
SecondaryPharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Area Under the Concentration-time Curve (AUC)

Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA). AUC24h (area under the curve from 0 to 24 hours) were determined using the linear-log trapezoidal rule.

Time frame:
At week 4
Reported as:
Median · hours*ng/mL
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Area Under the Concentration-time Curve (AUC)
hours*ng/mLArm AArm B
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Area Under the Concentration-time Curve (AUC)2747 (2146 to 3195)2546 (1833 to 3217)
SecondaryPharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Apparent Oral Clearance (CL/F)

Pharmacokinetic parameters were determined from plasma concentration-time profiles using noncompartmental methods (WinNonlin version 4.01, Pharsight Corp., Mountain View, CA).

Time frame:
At week 4
Reported as:
Median · mL/h
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Apparent Oral Clearance (CL/F)
mL/hArm AArm B
Pharmacokinetic Parameter for Delamanid Metabolite (DM-6705): Apparent Oral Clearance (CL/F)109223 (94181 to 139826)117827 (93270 to 163670)
SecondaryNumber of Participants With >90% Directly Observed Therapy Doses Taken During the Treatment Period

At each visit, the site reported the number of directly observed therapy (DOT) doses since the last visit. The number of expected DOT doses was 182. The number of expected DOT doses was adjusted by removing the number of days during temporary holds due to adverse events. This avoided penalizing participants who missed DOT doses due to protocol-required treatment holds for adverse events. Participants who missed DOT doses for other reasons were penalized even if they made up the missed doses by the week 30 study visit as allowed by the protocol. The proportion of expected 182 DOT doses was calculated as the total number of DOT doses reported by the site divided by the adjusted number of expected DOT doses.

Time frame:
Up to 26 weeks
Reported as:
Count of participants · Participants
Number of Participants With >90% Directly Observed Therapy Doses Taken During the Treatment Period
ParticipantsArm AArm B
Number of Participants With >90% Directly Observed Therapy Doses Taken During the Treatment Period3427
Statistical analysis
  • Arm A vs Arm B · Z-test, 2 sided · p = 0.30 · Risk difference (rd): -0.10 · 95% CI -0.27 to 0.07Difference in proportion (Arm B - Arm A).

Adverse events

Collected over From entry through Week 72. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Arm A0/69 (0%)14/69 (20.3%)52/69 (75.4%)
Arm B4/69 (5.8%)19/69 (27.5%)57/69 (82.6%)
Most frequent serious events
Showing 10 of 46
Most frequent serious events
EventArm AArm B
Electrocardiogram QT prolongedInvestigations2/694/69
Acute respiratory failureRespiratory, thoracic and mediastinal disorders0/693/69
PneumoniaInfections and infestations0/692/69
AnaemiaBlood and lymphatic system disorders1/691/69
Normochromic anaemiaBlood and lymphatic system disorders0/691/69
ThrombocytopeniaBlood and lymphatic system disorders0/691/69
Cor pulmonaleCardiac disorders1/690/69
Pericardial effusionCardiac disorders0/691/69
Abdominal pain lowerGastrointestinal disorders1/690/69
Alcoholic pancreatitisGastrointestinal disorders1/690/69
Most frequent other events
Showing 10 of 93
Most frequent other events
EventArm AArm B
Electrocardiogram QT prolongedInvestigations20/6929/69
Creatinine renal clearance decreasedInvestigations20/6916/69
Haemoglobin decreasedInvestigations13/6916/69
Alanine aminotransferase increasedInvestigations13/698/69
Neuropathy peripheralNervous system disorders13/696/69
AnaemiaBlood and lymphatic system disorders3/698/69
Aspartate aminotransferase increasedInvestigations7/693/69
ThrombocytopeniaBlood and lymphatic system disorders0/695/69
Bilirubin conjugated increasedInvestigations4/691/69
Blood lactic acid increasedInvestigations3/694/69

Baseline characteristics

Age, Continuous
Age, Continuous(years)Arm AArm BTotal
Mean35 ± 1237 ± 1436 ± 13
Age, Customized
Age, Customized(Participants)Arm AArm BTotal
Age category — 18 - <30282654
Age category — 30 - < 60393776
Age category — >= 60268
Sex: Female, Male
Sex: Female, Male(Participants)Arm AArm BTotal
Female252651
Male444387
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Arm AArm BTotal
American Indian or Alaska Native000
Asian201838
Native Hawaiian or Other Pacific Islander000
Black or African American414283
White011
More than one race8816
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(participants)Arm AArm BTotal
Haiti549
Botswana213
Philippines151227
Brazil4610
South Africa333568
Thailand5611
Peru5510
MTB Culture Result
MTB Culture Result(Participants)Arm AArm BTotal
MTB-Negative31114
MTB-Positive6558123
Indeterminate101
08

Study locations

13 sites
  • Gaborone CRS (Site ID: 12701)
    Gaborone, South-East District, Botswana
  • Instituto de Pesquisa Clinica Evandro Chagas (IPEC) CRS (Site ID: 12101)
    Rio de Janeiro, 21040-360, Brazil
  • GHESKIO Institute of Infectious Diseases and Reproductive Health (GHESKIO - IMIS) CRS (Site ID: 31730)
    Port-au-Prince, HT-6110, Haiti
  • Les Centres GHESKIO Clinical Research Site (GHESKIO-INLR) CRS (Site ID: 30022)
    Port-au-Prince, HT-6110, Haiti
  • Barranco CRS (Site ID: 11301)
    Lima, 15063, Peru
  • De La Salle Health Science Institute Angelo King Medical Research Center (DLSHSI-AKMRC) (Site ID: 31981)
    Cavite, 4114, Philippines
  • Wits Helen Joseph Hospital CRS (Wits HJH CRS) (Site ID: 11101)
    Johannesburg, Gauteng 2092, South Africa
  • Durban International CRS (Site ID: 11201)
    Durban, KwaZulu-Natal 4052, South Africa
  • Rustenburg CRS (Site ID: 31684)
    Rustenburg, North West 0300, South Africa
  • University of Cape Town Lung Institute (UCTLI) CRS (Site ID: 31792)
    Cape Town, Western Cape 7700, South Africa
  • South African Tuberculosis Vaccine Initiative (SATVI) CRS (Site ID: 31793)
    Cape Town, Western Cape 7705, South Africa
  • Thai Red Cross AIDS Research Centre (TRC-ARC) CRS (Site ID: 31802)
    Pathum Wan, Bangkok 10330, Thailand
  • Chiang Mai University HIV Treatment (CMU HIV Treatment) CRS (Site ID: 31784)
    Chiang Mai, 50200, Thailand
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Yes — Individual participant data that underlie results in the publication, after deidentification.

Supporting information: Study protocol, Statistical analysis plan

Time frame: Beginning 3 months following publication and available throughout period of funding of the ACTG (Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections) by NIH.

Access criteria: With whom? Researchers who provide a methodologically sound proposal for use of the data that is approved by the ACTG (Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections). For what types of analyses? To achieve aims in the proposal approved by the ACTG. By what mechanism will data be made available? Researchers may submit a request for access to data using the ACTG "Data Request" form at: https://actgnetwork.org/submit-a-proposal/. Researchers of approved proposals will need to sign an ACTG Data Use Agreement before receiving the data.

10

Updates

1 registry update since Sep 25, 2026
Results
Posted results revised
revised Oct 2, 2026
Secondary outcomes
6 description edited
What changed in the outcomes
  • DescriptionProportion of Participants Achieving Stable Liquid Culture Conversion: how it is measured was reworded
  • DescriptionProportion of Participants Achieving Stable Liquid Culture Conversion#2: how it is measured was reworded
  • DescriptionProportion of Participants Achieving Stable Liquid Culture Conversion#4: how it is measured was reworded
  • DescriptionProportion of Participants With Treatment-Related Adverse Events: how it is measured was reworded
  • DescriptionProportion of Participants With Unfavorable TB Treatment Outcome#2: how it is measured was reworded
  • DescriptionProportion of Participants With Unfavorable TB Treatment Outcome#3: how it is measured was reworded
Oct 2, 2026
Show all 1 update
  1. Oct 2, 2026
    Posted results revised
    Secondary outcomes 6 description edited
    What changed in the outcomes
    • DescriptionProportion of Participants Achieving Stable Liquid Culture Conversion: how it is measured was reworded
    • DescriptionProportion of Participants Achieving Stable Liquid Culture Conversion#2: how it is measured was reworded
    • DescriptionProportion of Participants Achieving Stable Liquid Culture Conversion#4: how it is measured was reworded
    • DescriptionProportion of Participants With Treatment-Related Adverse Events: how it is measured was reworded
    • DescriptionProportion of Participants With Unfavorable TB Treatment Outcome#2: how it is measured was reworded
    • DescriptionProportion of Participants With Unfavorable TB Treatment Outcome#3: how it is measured was reworded
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

11

Registry details

Key details

Study ID
NCT05007821
Responsible party
Sponsor
First posted
Aug 16, 2021
Start date
Sep 27, 2022
Primary completion
Mar 14, 2025
Completion
Jan 13, 2026
Results posted
May 1, 2026
Last update
Oct 2, 2026

Study contacts

Constance A. Benson
study chair · The University of California, San Diego

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Linezolid

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