Trial Outcomes & Findings for Tuberculosis Research of INA-RESPOND On Drug Resistance (NCT NCT02758236)

NCT ID: NCT02758236

Last Updated: 2024-05-16

Results Overview

AFB smear and GeneXpert were performed at the microbiology laboratory of the study site. Culture and drug susceptibility tests were conducted at appointed National TB Program Reference Laboratories.

Recruitment status

COMPLETED

Target enrollment

490 participants

Primary outcome timeframe

2 months after enrollment

Results posted on

2024-05-16

Participant Flow

The recruitment period was from February 2017 through November 2018. The study was done at 7 hospitals in Indonesia.

From total target 1357 subjects, only achieved 490 subjects enrolled.

Participant milestones

Participant milestones
Measure
Presumptive TB
TB patients with cough for 2 weeks or longer with at least one additional TB symptom and a chest x-ray suggestive of TB.
Overall Study
STARTED
490
Overall Study
COMPLETED
447
Overall Study
NOT COMPLETED
43

Reasons for withdrawal

Reasons for withdrawal
Measure
Presumptive TB
TB patients with cough for 2 weeks or longer with at least one additional TB symptom and a chest x-ray suggestive of TB.
Overall Study
Investigator discretion
43

Baseline Characteristics

Total excluded was 43 participants

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Presumptive TB
n=447 Participants
TB patients with cough for 2 weeks or longer with at least one additional TB symptom and a chest x-ray suggestive of TB.
Age, Categorical
<=18 years
0 Participants
n=99 Participants • Total excluded was 43 participants
Age, Categorical
Between 18 and 65 years
426 Participants
n=99 Participants • Total excluded was 43 participants
Age, Categorical
>=65 years
21 Participants
n=99 Participants • Total excluded was 43 participants
Sex: Female, Male
Female
173 Participants
n=99 Participants • Total excluded was 43 participants
Sex: Female, Male
Male
274 Participants
n=99 Participants • Total excluded was 43 participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=99 Participants • Total excluded was 43 participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
447 Participants
n=99 Participants • Total excluded was 43 participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants • Total excluded was 43 participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants • Total excluded was 43 participants
Race (NIH/OMB)
Asian
447 Participants
n=99 Participants • Total excluded was 43 participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants • Total excluded was 43 participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants • Total excluded was 43 participants
Race (NIH/OMB)
White
0 Participants
n=99 Participants • Total excluded was 43 participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants • Total excluded was 43 participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants • Total excluded was 43 participants

PRIMARY outcome

Timeframe: 2 months after enrollment

Population: TB cases with bacteriologically confirmed TB with positive MTB culture

AFB smear and GeneXpert were performed at the microbiology laboratory of the study site. Culture and drug susceptibility tests were conducted at appointed National TB Program Reference Laboratories.

Outcome measures

Outcome measures
Measure
MDR TB Amongst New TB Cases
n=260 Participants
New TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
MDR TB Amongst Previously Treated TB Cases
n=187 Participants
Previously treated TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
Sensitivity Xpert MTB/RIF
Subjects that had positive sputum culture were used for evaluation of sensitivity.
Specificity Xpert MTB/RIF
Subjects that had no bacterial evidence of MTB infection (AFB, culture, and Xpert negative) and subjects that were only AFB and/or Xpert MTB/RIF positive were used to evaluate the specificity.
Number of MDR TB Cases Amongst New TB Cases and Previously Treated TB Cases
23 Participants
64 Participants

SECONDARY outcome

Timeframe: 12- 30 months

Population: The proportion of treatment outcomes from all subjects with bacteriologically confirmed (n=328 subjects)

From 447 subjects with all sputum examination results, only 328 subjects confirmed by bacteriology and the treatment outcome were categorized as followed: 1. Cured 2. Failed 3. Died 4. Treatment completion 5. Lost to follow up

Outcome measures

Outcome measures
Measure
MDR TB Amongst New TB Cases
n=328 Participants
New TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
MDR TB Amongst Previously Treated TB Cases
Previously treated TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
Sensitivity Xpert MTB/RIF
Subjects that had positive sputum culture were used for evaluation of sensitivity.
Specificity Xpert MTB/RIF
Subjects that had no bacterial evidence of MTB infection (AFB, culture, and Xpert negative) and subjects that were only AFB and/or Xpert MTB/RIF positive were used to evaluate the specificity.
Number of Participants Who Were Cured, Failed, Died, Treatment Completion, and Lost to Follow-up
Cured
222 Participants
Number of Participants Who Were Cured, Failed, Died, Treatment Completion, and Lost to Follow-up
Failed
12 Participants
Number of Participants Who Were Cured, Failed, Died, Treatment Completion, and Lost to Follow-up
Died
31 Participants
Number of Participants Who Were Cured, Failed, Died, Treatment Completion, and Lost to Follow-up
Treatment complete
15 Participants
Number of Participants Who Were Cured, Failed, Died, Treatment Completion, and Lost to Follow-up
Treatment lost to follow-up
48 Participants

SECONDARY outcome

Timeframe: 12-30 months

Population: Treatment success was defined as cured or complete treatment.

Protective factors were collected by interview with the subjects. 237 subjects with confirmed bacteriologically and cured or complete treatment were analyzed for this outcome.

Outcome measures

Outcome measures
Measure
MDR TB Amongst New TB Cases
n=237 Participants
New TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
MDR TB Amongst Previously Treated TB Cases
Previously treated TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
Sensitivity Xpert MTB/RIF
Subjects that had positive sputum culture were used for evaluation of sensitivity.
Specificity Xpert MTB/RIF
Subjects that had no bacterial evidence of MTB infection (AFB, culture, and Xpert negative) and subjects that were only AFB and/or Xpert MTB/RIF positive were used to evaluate the specificity.
Factors for Treatment Success.
Males
143 Participants
Factors for Treatment Success.
Non-Smoking Group
204 Participants
Factors for Treatment Success.
Normal/overweight (BMI>=18)
125 Participants
Factors for Treatment Success.
New TB cases
146 Participants
Factors for Treatment Success.
Lung lesion in CXR > 2 zones
175 Participants

SECONDARY outcome

Timeframe: 12-30 months

Population: Risk factors of treatment interruption were collected by interview with the subject. 91 subjects were defined as lost to follow-up or treatment failure or died and analyzed for this outcome.

Risk factors of treatment interruption were collected by interview with the subject. 91 subjects were defined as lost to follow-up or treatment failure or died and analyzed for this outcome.

Outcome measures

Outcome measures
Measure
MDR TB Amongst New TB Cases
n=91 Participants
New TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
MDR TB Amongst Previously Treated TB Cases
Previously treated TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
Sensitivity Xpert MTB/RIF
Subjects that had positive sputum culture were used for evaluation of sensitivity.
Specificity Xpert MTB/RIF
Subjects that had no bacterial evidence of MTB infection (AFB, culture, and Xpert negative) and subjects that were only AFB and/or Xpert MTB/RIF positive were used to evaluate the specificity.
Factors of Treatment Interruption.
Male group
56 Participants
Factors of Treatment Interruption.
Non-smoking group
81 Participants
Factors of Treatment Interruption.
Underweight (BMI<18)
51 Participants
Factors of Treatment Interruption.
Previously treated
54 Participants
Factors of Treatment Interruption.
Lung lesion in CXR >2 zones
75 Participants

SECONDARY outcome

Timeframe: 12-30 months

Population: TB category was defined as clinically TB or bacteriologically confirmed TB. 447 subjects with sputum examination were analyzed for this outcome.

TB category was defined as clinically TB or bacteriologically confirmed TB. 447 subjects with sputum examination were analyzed for this outcome.

Outcome measures

Outcome measures
Measure
MDR TB Amongst New TB Cases
n=447 Participants
New TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
MDR TB Amongst Previously Treated TB Cases
n=447 Participants
Previously treated TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
Sensitivity Xpert MTB/RIF
Subjects that had positive sputum culture were used for evaluation of sensitivity.
Specificity Xpert MTB/RIF
Subjects that had no bacterial evidence of MTB infection (AFB, culture, and Xpert negative) and subjects that were only AFB and/or Xpert MTB/RIF positive were used to evaluate the specificity.
TB Case Category
99 Participants
348 Participants

SECONDARY outcome

Timeframe: 12-30 months

Population: Assess the sensitivity and specificity of AFB and Xpert MTB/RIF to culture as gold standard. 312 subjects had positive sputum culture were used for evaluation of sensitivity. Meanwhile, 99 subjects that had no bacterial evidence of MTB infection (AFB, culture, and Xpert negative) and 36 subjects that were only AFB and/or Xpert MTB/RIF positive were used to evaluate the specificity. In total 135 subjects were analyzed to evaluate the specificity.

Assess the sensitivity and specificity of AFB and Xpert MTB/RIF to culture as gold standard. 312 subjects had positive sputum culture were used for evaluation of sensitivity. Meanwhile, 99 subjects that had no bacterial evidence of MTB infection (AFB, culture, and Xpert negative) and 36 subjects that were only AFB and/or Xpert MTB/RIF positive were used to evaluate the specificity. In total 135 subjects were analyzed to evaluate the specificity.

Outcome measures

Outcome measures
Measure
MDR TB Amongst New TB Cases
n=312 Participants
New TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
MDR TB Amongst Previously Treated TB Cases
n=135 Participants
Previously treated TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
Sensitivity Xpert MTB/RIF
n=312 Participants
Subjects that had positive sputum culture were used for evaluation of sensitivity.
Specificity Xpert MTB/RIF
n=135 Participants
Subjects that had no bacterial evidence of MTB infection (AFB, culture, and Xpert negative) and subjects that were only AFB and/or Xpert MTB/RIF positive were used to evaluate the specificity.
The Performance of AFB and Xpert MTB/RIF
269 Participants
117 Participants
304 Participants
99 Participants

SECONDARY outcome

Timeframe: 12-30 months

Population: Assess the performance of Rifampicin susceptibility results in Xpert MTB/RIF against result in drug susceptible test (DST) as gold standard. 312 subjects had positive sputum culture were used to assess the performance of Xpert MTB/RIF. 196 subjects were sensitive to Rif in Xpert MTB/RIF. While 116 subjects had resistant to Rif in Xpert MTB/RIF.

Assess the performance of Rifampicin susceptibility results in Xpert MTB/RIF against result in drug susceptible test (DST) as gold standard. 312 subjects had positive sputum culture were used to assess the performance of Xpert MTB/RIF. 196 subjects were sensitive to Rif in Xpert MTB/RIF. While 116 subjects had resistant to Rif in Xpert MTB/RIF.

Outcome measures

Outcome measures
Measure
MDR TB Amongst New TB Cases
n=196 Participants
New TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
MDR TB Amongst Previously Treated TB Cases
n=116 Participants
Previously treated TB cases with bacteriologically confirmed TB with positive MTB culture and categorized as having MDR-TB
Sensitivity Xpert MTB/RIF
Subjects that had positive sputum culture were used for evaluation of sensitivity.
Specificity Xpert MTB/RIF
Subjects that had no bacterial evidence of MTB infection (AFB, culture, and Xpert negative) and subjects that were only AFB and/or Xpert MTB/RIF positive were used to evaluate the specificity.
The Performance of Xpert MTB/RIF
Xpert resistant
25 Participants
112 Participants
The Performance of Xpert MTB/RIF
Xpert negative
6 Participants
2 Participants
The Performance of Xpert MTB/RIF
Xpert sensitive
165 Participants
2 Participants

Adverse Events

Presumptive TB

Serious events: 0 serious events
Other events: 0 other events
Deaths: 65 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Publication Division

INA-RESPOND

Phone: +62214208693

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place