Status:

NOT_YET_RECRUITING

A Trial of 2 Disease-Modifying Drugs (Metformin and N-acetylcysteine ) to Promote TB Lung Function Recovery

Lead Sponsor:

Open Source Pharma Foundation

Collaborating Sponsors:

National Institute for Research in Tuberculosis, Chennai, India

Conditions:

Tuberculosis

Eligibility:

All Genders

18-65 years

Phase:

PHASE3

Brief Summary

Tuberculosis is a leading global cause of morbidity and mortality. Even if cured, a majority patients are left with bronchiectasis and fibrosis, permanent conditions that impair lung function. Large c...

Detailed Description

Tuberculosis is a leading global cause of morbidity and mortality. Current treatments are inadequate, requiring patients closely adhere to multi-drug regimens that are long, complex, and often poorly ...

Eligibility Criteria

Inclusion

  • Willing and able to provide signed written consent (or, in the case of illiteracy, witnessed oral consent plus patient thumbprint) prior to undertaking any trial-related procedures.
  • Body weight (in light clothing without shoes) between 30 and 90 kg.
  • Radiographic evidence of pulmonary tuberculosis
  • Positive Xpert TB/RIF (original or Ultra) for MTB
  • RIF susceptibility diagnosed by Xpert TB/RIF, with subsequent culture confirmation
  • FEV1≤65% of predicted
  • Eligible for treatment with a 6-month regimen comprised of INH, RIF, EMB, and PZA
  • If sexually active, willing to use effective contraceptive methods for a period of 9 months (3 months post-study treatment)
  • HIV-1 seronegative, or if HIV-1 seropositive, presenting to a non-India clinical site with a CD4 T cell count ≥100/µl and either receiving ART or willing to start ART during study participation
  • SARS-CoV-2 PCR or antigen test negative, or if positive, either fully vaccinated against Covid-19 or with D-dimer \<1 µg/ml
  • eGFR ≥30 ml/min/1.73 m2 (CKD EPI 2009)

Exclusion

  • Any condition for which participation in the trial, as judged by the investigator, could compromise the well-being of the subject or prevent, limit or confound protocol specified assessments
  • Currently pregnant or nursing, or pregnancy planned in next 12 months
  • Is critically ill, and in the judgment of the investigator has a diagnosis likely to result in death during the trial or the follow-up period.
  • TB meningitis or spondylitis, or other forms of severe tuberculosis with high risk of a poor outcome as judged by the investigator.
  • History of allergy or hypersensitivity to any of the trial therapies or related substances.
  • History of a chronic lung condition (including COPD or asthma) requiring treatment in the previous year
  • Having participated in other clinical trials with investigational agents within 8 weeks prior to trial start or currently enrolled in an investigational trial.
  • Prior TB treatment in the preceding 6 months, other than within the 7 days immediately prior to enrollment.
  • Angina pectoris requiring treatment with nitroglycerin or other nitrates
  • Cardiac arrhythmia requiring medication, or any clinically significant ECG abnormality, in the opinion of the investigator
  • History of diabetes mellitus requiring treatment with metformin or resulting in hospitalization for hyper- or hypoglycaemia within the past year prior to start of screening
  • Use of systemic corticosteroids within the past 28 days.
  • Patients requiring treatment with medications not compatible with rifampin, such as HIV-1 protease inhibitors
  • History of Pneumoconiosis.
  • Subjects with any of the following abnormal laboratory values: hemoglobin \<8 g/dL, platelets \<100x109 cells/L, serum potassium \<3.5 mM/L, alanine aminotransferase (ALT) ≥2.0 x ULN, alkaline phosphatase (AP) \>5.0 x ULN, total bilirubin \>1.5 mg/dL, HbA1c \>6.5 %

Key Trial Info

Start Date :

January 1 2026

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

July 1 2031

Estimated Enrollment :

1104 Patients enrolled

Trial Details

Trial ID

NCT07136987

Start Date

January 1 2026

End Date

July 1 2031

Last Update

August 22 2025

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