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Active, not recruitingNCT06649721INSPIRE-BDLLUpdated Sep 2, 2025

Innovating Shorter, All- Oral, Precised Treatment Regimen for Rifampicin Resistant Tuberculosis:BDLL Chinese Cohort

A Phase 3 interventional study of bedaquiline and delamanid in Drug-resistant Tuberculosis, Pulmonary Tuberculosis and Rifampin-resistant Tuberculosis, sponsored by Huashan Hospital. Active, not recruiting at 34 sites in China. Open to participants aged 12 Years and older. Per ClinicalTrials.gov, last updated 2025-09-02.

Sponsored by Huashan Hospital · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
120
Allocation
Not applicable
Ages
12 Years and older
Sex
All
01

Study summary

This is an investigational, prospective, multicenter, single-arm, open label trial. The goal of this clinical trial is to evaluate the efficacy and safety of a 6-month all-oral regimen, consisting of Bedaquiline (BDQ, B), Delamanid (DLM, D), Linezolid (LZD, L), Levofloxacin (LFX) or Clofazimine (CFZ, C), or BDLLfxC regimen, to treat rifampin-resistant pulmonary tuberculosis (RR-TB) in Chinese teenagers and adults (aged 12 years or above). The main questions it aims to answer are:

  • Is BDLLfxC regimen effective to treat RR-TB in Chinese participants?
  • Is BDLLfxC regimen safe in Chinese RR-TB participants? Participants will take BDLLfxC regimen to treat their RR-TB. There will be no additional hospital visits, laboratory tests or radiological examinations other than routine clinical practice.
02

Conditions studied

  • Drug-resistant Tuberculosis
  • Pulmonary Tuberculosis
  • Rifampin-resistant Tuberculosis

Keywords

  • Drug-resistant tuberculosis
  • BDLL
  • Chinese Population
  • Short regimen
03

In context

Tuberculosis, Multidrug-Resistant

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

This study's planned enrollment of 120 is below the median of 150 across 81 interventional studies indexed under Tuberculosis, Multidrug-Resistant.

Browse Tuberculosis, Multidrug-Resistant studies →

Lead sponsor

Huashan Hospital is the lead sponsor of 239 studies on the registry; 102 are open to participants now.

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

04

Who can participate

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

Inclusion criteria

  • Participants are willing to sign informed consent of this trial, those without capacity for civil conduct need their legal guardian to sign
  • Participants (and their legal guardian if applicable) are willing to cooperate to complete all trial procedures
  • Male or female, 12 years or older, weight ≥ 30kg
  • Confirmed pulmonary tuberculosis with resistance to rifampin by phenotypic or genotypic susceptibility testing within 3 months, and must be re-confirmed by sputum culture sampled at trial inclusion
  • Women with childbearing potential should not be pregnant, confirmed by a volunteered negative pregnancy test, and are willing to use effective contraceptive method from giving consent to 3 months after study treatment
  • Men with childbearing potential must be willing to use condom or other effective contraceptive methods to avoid their sex partners from being pregnant
  • Women in breastfeeding period must be willing to discontinue breastfeeding from giving consent to 3 months after study treatment
  • Participants are willing to take HIV test, and willing to take appropriate antiretroviral therapy if positive

Exclusion criteria

Exclusion Criteria:

  • Previously use of Bedaquiline or Delamanid for at least 28 days
  • Concomitant hematogenous disseminated tuberculosis, or severe pulmonary tuberculosis in investigator's opinion (including tuberculosis of the digestive system, osteoarticular tuberculosis or tuberculous meningitis)
  • Currently using any drug that has been prohibited in the protocol
  • History of allergic action to any of the study drugs
  • Currently participating in any other clinical trials
  • Cardiovascular risk at screening: (1) QTcF more than 480 milliseconds (ms); (2) History of clinically significant arrythmia, and at investigator's opinion, participation in this study will increase the risk; (3) Decompensated heart failure; (4) Grade 3 high blood pressure and the goals of treatment have not been reached; (5) Abnormal thyroid function; (6) Abnormal serum Ca, Mg or K level; (7) Other conditions with cardiovascular risks in investigator's opinion.
  • History of optic neuropathy or peripheral neuropathy, and the investigator considers that the condition may progress or deteriorate by participating in the study, or inappropriate to participate
  • Hepatic disorders at screening: (1) Active viral hepatitis: HBsAg positive or HBV DNA >1000 CPs/mL, with elevated AST or ALT or HCV RNA positive; (2) Decompensated cirrhosis
  • Renal disorders at screening: (1) Unstable or rapidly progressive renal disease; (2) Moderate / severe renal disfunction or end-stage renal disease (eGFR\< 60 mL/min/1.73 m2); (3) Serum creatinine ≥133 μmol/L(1.5 mg/mL) in men, or ≥124 μmol/L (1.4 mg/mL) in women
  • Other abnormal laboratory test: (1) Hemoglobin \< 8.0g/dL; (2) Platelet \<75,000/mm3; (3) Absolute neutrophil count \<1000/mm3; (4) Aspartate transaminase (AST) or alanine aminotransferase (ALT) >3×upper limit of normal (ULN); (5) Total bilirubin (TBil) >2×ULN, or >1.5×ULN together with abnormal AST or ALT; (6) Albumin \<30g/L
  • The investigator considers that the participant is not able to complete the study process, or the participation is not safe.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
120 participants (estimated)

Study arms

  • Experimental
    BDLL

    6-month all-oral regimen, consisting of Bedaquiline (BDQ, B), Delamanid (DLM, D), Linezolid (LZD, L), Levofloxacin (LFX) or Clofazimine (CFZ, C), as known as BDLLfxC or BDLL regimen

    Drug: bedaquiline · Drug: delamanid · Drug: linezolid · Drug: Levofloxacin · Drug: Clofazimine

Interventions

  • Drugbedaquiline

    400 milligrams (mg) daily for 2 weeks(w), then 200mg three times a week for 22 weeks (w)

    Also known as: BDQ, B

  • Drugdelamanid

    * for participants weighing up to 33.9 kilograms (kg): 50mg two times a day for 24w * for participants weighing 34kg or above: 100mg two times a day for 8w, then 200mg daily for 16w

    Also known as: DLM, D

  • Druglinezolid

    * for participants weighing up to 33.9kg: 450mg daily; * for participants weighing 34kg or above: 600mg daily; for 24w if a negative culture is obtained from sputum collected at 16w, or else for 36w

    Also known as: LZD, L

  • DrugLevofloxacin

    Only for participants with confirmed fluoroquinolone-susceptible TB or unknown fluoroquinolone susceptibility: * for participants weighing up to 33.9kg: 500mg daily * for participants weighing 34kg to 49.9kg: 750 daily * for participants weighing 50kg or above: 1000mg daily for 24w if a negative culture is obtained from sputum collected at 16w, or else for 36w

    Also known as: LFX

  • DrugClofazimine

    Only for participants with confirmed fluoroquinolone-resistant TB or unknown fluoroquinolone susceptibility: 100mg daily, for 24w if a negative culture is obtained from sputum collected at 16w, or else for 36w

    Also known as: CFZ, C

06

What researchers measure

Primary outcomes

  1. Proportion of participants with favorable outcomes in both treatment and follow-up period

    Favorable outcome in treatment period (up to 28 weeks after start of treatment): a participant's outcome will be defined as "favorable" if it meets any of the following below and has not been defined as "unfavorable" before, 1. . Cured: complete at least 80% of total required dose per protocol, with negative culture results of last two sputum samples (collected 14 days apart) ; 2. . Treatment completed: complete at least 80% of total required dose per protocol, with NO negative culture results of last two sputum samples (collected 14 days apart); Favorable outcome in follow-up period (from end of treatment to 72 weeks after start of treatment): a participant's outcome will be defined as "favorable" if it meets any of the following below and has not been defined as "unfavorable" before, (1). Cured: sputum culture negative at 72 weeks from start of treatment; (2). Culture negative when last seen: loss to follow-up before 72 weeks, with negative sputum culture when last seen.

    Time frame: Up to 72 weeks after start of treatment

Secondary outcomes

  1. Proportion of participants with grade 3 or 4 adverse effect

    Adverse effect will be graded using Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1.

    Time frame: Up to 72 weeks after start of treatment

  2. Proportion of participants with favorable outcomes in treatment period, follow-up period and prolonged follow-up period, respectively

    The definitions of favorable outcome in treatment and follow-up period are as described in primary outcome. Favorable outcome in prolonged follow-up period (from end of treatment to 108 weeks after start of treatment): a participant's outcome will be defined as "favorable" if it meets any of the following below and has not been defined as "unfavorable" before, (1). Cured: sputum culture negative at 108 weeks from start of treatment; (2). Culture negative when last seen: loss to follow-up before 108 weeks, with negative sputum culture when last seen.

    Time frame: Up to 108 weeks after start of treatment

  3. Time to culture conversion

    Time from start of treatment to the first time that obtained two consecutive negative sputum culture results, and the sputum samples must be collected 14 days apart. The date when first sputum sample is collected will be recorded as the date for culture conversion.

    Time frame: Up to 72 weeks after start of treatment

07

Study locations

34 sites
  • Anhui Chest Hospital
    Hefei, Anhui, China
  • The 8th Medical Center of Chinese PLA General Hospital
    Beijing, Beijing Municipality, China
  • The First Affiliated Hospital of Xiamen University
    Xiamen, Fujian, China
  • The Fourth People's Hospital of Nanning
    Nanning, Guangxi, China
  • Liupanshui Third People's Hospital
    Liupanshui, Guizhou, China
  • Hebei Chest Hospital
    Shijiazhuang, Hebei, China
  • The Fifth Hospital of Shijiazhuang
    Shijiazhuang, Hebei, China
  • Infectious Disease Hospital of Heilongjiang Province
    Harbin, Heilongjiang, China
  • Jiamusi Tuberculosis Hospital(Jiamusi Cancer Hospital)
    Jiamusi, Heilongjiang, China
  • Harbin Chest Hospital
    Harbin, Helongjiang, China
  • Luoyang Center Hospital
    Luoyang, Henan, China
  • The First Affiliated Hospital of Xinxiang Medical University
    Xinxiang, Henan, China
  • Henan Chest Hospital
    Zhengzhou, Henan, China
  • Henan Infectious Disease Hospital
    Zhengzhou, Henan, China
  • Wuhan Pulmonary Hospital,Wuhan Tuberculosis Prevention and Control Institute
    Wuhan, Hubei, China
  • Changsha Central Hospital
    Changsha, Hunan, China
  • Hulunbuir Infectious Disease Hospital
    Hulunbuir, Inner Mongolia, China
  • The Second Hospital of Nanjing
    Nanjing, Jiangsu, China
  • Jiangxi Chest Hospital
    Nanchang, Jiangxi, China
  • Infectious Disease Hospital of Changchun
    Changchun, Jilin, China
  • Jilin Tuberculosis Hospital
    Jilin City, Jilin, China
  • Shenyang Chest Hospital
    Shenyang, Liaoning, China
  • Xi'an Chest Hospital
    Xi'an, Shaanxi, China
  • Shandong Public Health Clinical Center, Shandong University
    Jinan, Shandong, China
  • Linyi People Hospital
    Linyi, Shandong, China
  • Qingdao Chest Hospital
    Qingdao, Shandong, China
  • Weifang No.2 People's Hospital
    Weifang, Shandong, China
  • Yantai Qishan Hospital
    Yantai, Shandong, China
  • Shanxi Medical University Affiliated Chest Hospital
    Taiyuan, Shanxi, China
  • Public Health Clinical Center of Chengdu
    Chengdu, Sichuan, China
  • Tianjin Haihe Hospital
    Tianjin, Tianjin Municipality, China
  • Wenzhou Central Hospital
    Wenzhou, Zhejiang, China
  • Beijing Chest Hospital
    Beijing, China
  • Huashan Hospital
    Shanghai, China
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 Sep 2, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06649721
Lead sponsor
Huashan Hospital
Collaborators
Beijing Chest Hospital
Responsible party
Wen-hong Zhang (Head of Infectious Disease Department, Huashan Hospital) — Principal investigator
First posted
Oct 21, 2024
Start date
Nov 27, 2024
Primary completion
Feb 28, 2027 (estimated)
Completion
Jun 30, 2027 (estimated)
Last update
Sep 2, 2025

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in Aug 2025. You cannot join it, but the record below documents what was studied.

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