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Telacebec (T) Treatment in Adults with Buruli Ulcer (BU).

PHASE2RECRUITING

The goal of this interventional clinical trial is to determine if treatment with 4 weeks of telacebac (T) will completely heal lesions in participants with Buruli ulcer (BU) by 52 weeks after treatment initiation, without relapse and/or surgery. Males and females age 18 and older will be included. * Participants will attend visits every week during treatment (4 weeks) * Thereafter they will be followed every 2 weeks until week 24 followed by visits as weeks 30, 40 and 52.

* Dependent on site requirements, there may be follow up visits on site or remotely.

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Study details:

This is an open label single arm (telacebec), multi-centre, clinical trial. Eligible participants with clinically diagnosed World Health Organization (WHO) category I lesions and category II lesions ≤10 cm cross-sectional diameter and category III lesions where multiple and all lesions are ≤10 cm cross-sectional diameter, confirmed by polymerase chain reaction (PCR) or culture for presence of Mycobacterium ulcerans infection, will receive telacebec 300 mg orally once daily for 28 days with food. Participants who meet entry criteria and give consent will attend a baseline enrolment visit (Day 1), then visits every week for 4 weeks during treatment (weeks 1, 2, 3 and 4).

Thereafter they will be followed up every 2 weeks until week 24, followed by visits at weeks 30, 40, and 52. BU lesion management will be provided to all trial participants. In case of participant early withdrawal from the trial during or after the treatment period, participants will be treated per the investigational site and/or country BU treatment guidelines.

A Data Review Committee (DRC) will be established to review efficacy and safety data. Enrolment and enrolled participants will continue the study whilst the DRC reviews are ongoing.

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Eligibility criteria

Researchers look for people who fit a certain description, called eligibility criteria. See if you qualify.

Inclusion criteria

  • Clinical diagnosis of BU WHO categories, single or multiples: 1. I 2. II with a cross-sectional diameter < 10 cm 3. III category III lesions where multiple and all are < 10 cm cross-sectional diameter
  • Positive PCR or culture for confirmation of presence of mycobacterium ulcerans (MU).
  • Exclusion criteria

  • Participants with the following known or suspected medical conditions: 1. Any non BU related condition where participation in the study, as judged by the Investigator, could compromise the well-being of the participant or prevent, limit or confound protocol specified treatment and assessments.
  • History or current ascites, jaundice, myasthenia gravis, clinically significant renal dysfunction [estimated glomerular filtration rate (eGFR) < 50 mls/min], uncontrolled diabetes mellitus [glycated heaemoglobin (HbA1C )> 10%], and severe immune compromise (e.g., immunosuppressive drugs after organ transplant)
  • History of previous BU (except current infection)
  • Planned/expected to require curative intent excision surgery, defined as excision of lesion which may include surrounding macroscopically healthy tissue with the aim of helping to sterilize the wound rather than improve wound healing alone, for their BU during the entire study period. Simple removal of necrotic slough and skin grafting is considered normal wound care and allowed.
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    Eligibility

    Age eligible for study : 18 and older

    Healthy volunteers accepted : No

    Gender eligible for study: All

    Things to know

    Study dates

    Study start: 2024-07-09

    Primary completion: 2024-12-01

    Study completion finish: 2025-12-01

    study type

    Study type

    TREATMENT

    phase

    Phase

      PHASE2

    trial

    Trial ID

    NCT06481163

    Intervention or treatment

    DRUG: Telacebec

    Conditions

    • Buruli Ulcer

    Find a site

    Closest Location:

    Royal Melbourne Hospital

    Research sites nearby

    Select from list below to view details:

    • Royal Melbourne Hospital

      Melbourne, Not Specified, Australia

    • Barwon Health

      Geelong, Victoria, Australia

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    Study Plan

    This section provides details of the study plan, including how the study is designed and what the study is measuring.

    How is the study designed?

    Participant Group/ArmIntervention/Treatment
    EXPERIMENTAL: 300 mg Telacebec per day
    • Telacebec will be administered orally with food or within 30 minutes after food once daily for 28 consecutive days.
    DRUG: Telacebec
    • The test product will be supplied as Telacebec 100mg tablets.

    What is the study measuring?

    Primary outcome

    Primary Outcome MeasurePrimary Outcome DescriptionPrimary Outcome Time Frame
    Rate of complete lesion healing by 52 weeks from treatment initiation.Ulcerated Lesions: Healing and re-epithelialisation of ulcerated area with stable scar formation. Non-ulcerated Lesions: resolution of induration of skin. Complete healing rate will be summarized as percentage with corresponding Clopper-Pearson 95% confidence interval.52 weeks from treatment initiation

    Secondary outcome

    Secondary Outcome MeasureSecondary Outcome DescriptionSecondary Outcome Time Frame
    Complete lesion healing rate at 52 weeks from treatment initiation.Complete healing rate will be summarized as percentage with corresponding Clopper-Pearson 95% confidence interval.52 weeks from treatment initiation
    Median time to healingKaplan-Meier methods will be applied to estimate median time to healing.52 weeks from treatment initiation
    Recurrence rate within 52 weeks from treatment initiationComplete lesion healing followed by a recurrent lesion at the same site or a new lesion appearing at a separate site, detected within 52 weeks of treatment initiation, that is culture positive and not judged to be due to a paradoxical response to telacebec treatment on clinical and/or histological findings.52 weeks from treatment initiation
    Treatment failure rate within 52 weeks from treatment initiationLack of complete healing within the 52 weeks observation period; Recurrence, Use of alternative buruli ulcer (BU) treatment, BU curative intent surgery52 weeks from treatment initiation
    Paradoxical response rate with 52 weeks from treatment initiationAn increase in lesion surface area by more than 20% compared with a previous measurement, after initial reduction in lesion size, or the development of a new lesion appearing at a separate site that does not show evidence of disease relapse on histopathology and/or mycobacterial culture examination.52 weeks from treatment initiation

    Frequently Asked Questions

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    References

    Clinical Trials Gov: Telacebec (T) Treatment in Adults with Buruli Ulcer (BU).

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