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NCT Number: NCT07668479

Rifapentine-Based Shorter Regimens for Tuberculosis and TB Infection in Kazakhstan

RIFA-REAL is a prospective observational longitudinal study evaluating the safety, feasibility, and effectiveness of rifapentine-based shorter treatment regimens for drug-susceptible tuberculosis (DS-TB) and tuberculosis infection (TBI) under routine programmatic conditions in Kazakhstan.

The study enrolls three cohorts: patients with DS-TB receiving the 4-month isoniazid-rifapentine-moxifloxacin-pyrazinamide regimen (2HPMZ/2HPM), patients with DS-TB receiving the standard 6-month isoniazid-rifampicin-pyrazinamide-ethambutol regimen (2HRZE/4HR), and individuals with TBI receiving the 1-month rifapentine-isoniazid regimen (1HP). Participants include people living with and without HIV.

The study is conducted across four regions of Kazakhstan and is funded through the Western-Eastern European Partnership Initiative on HIV, Viral Hepatitis and TB (WEEPI) grant. Findings will inform national TB policy and contribute to global evidence on programmatic implementation of rifapentine-based regimens.

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Key information

Conditions

Tuberculosis Actinomycetales Infections Bacterial Infections Bacterial Infections and Mycoses Gram-Positive Bacterial Infections Infections Latent Infection Latent Tuberculosis Mycobacterium Infections Tuberculosis Infection, Latent Tuberculosis, Pulmonary, Drug Sensitive

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

About this study

Despite World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and European Respiratory Society (ERS) recommendations, uptake of shorter rifapentine-based regimens for DS-TB (2HPMZ/2HPM) and TBI (1HP) remains limited due to concerns about adverse events and lack of real-world implementation evidence.

This study prospectively follows three cohorts over 12 months from treatment initiation. Primary outcomes include favourable treatment outcomes at 12 months (DS-TB cohorts), cumulative incidence and severity of serious adverse events (all cohorts), and key feasibility indicators including recruitment rates, retention, adherence, and treatment completion.

The study was approved by the Local Bioethics Committee of the National Center for Public Health, Ministry of Health of Kazakhstan (Protocol No. 2026-LKB-004-P, 29 April 2026).

Who can participate

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

FOR DS-TB COHORTS (2HPMZ/2HPM and 2HRZE/4HR):

  • Age 18 years or older
  • Bacteriologically confirmed drug-susceptible pulmonary tuberculosis
  • Newly diagnosed, not previously treated (or treated less than 1 month)
  • Willing and able to provide written informed consent
  • Residing in one of the four pilot regions of Kazakhstan

FOR TBI COHORT (1HP):

  • Age 18 years or older
  • Diagnosed with tuberculosis infection
  • No evidence of active tuberculosis disease
  • Willing and able to provide written informed consent
  • Residing in one of the four pilot regions of Kazakhstan

Exclusion criteria

FOR DS-TB COHORTS:

  • Confirmed or suspected drug-resistant tuberculosis (rifampicin-resistant tuberculosis (RR-TB) or multidrug-resistant tuberculosis (MDR-TB))
  • Extrapulmonary tuberculosis as the sole manifestation
  • Pregnancy or breastfeeding at time of enrollment
  • Severe hepatic impairment (alanine aminotransferase (ALT)/aspartate aminotransferase (AST) >3x upper limit of normal)
  • Known hypersensitivity to rifapentine, isoniazid, moxifloxacin, or pyrazinamide
  • corrected QT interval (QTc) interval >500 ms on baseline electrocardiogram (ECG)
  • Currently receiving medications with significant interactions contraindicated with study regimens

FOR TBI COHORT:

  • Active tuberculosis disease
  • Previous treatment for TB or TBI within the past 2 years
  • Pregnancy at time of enrollment
  • Severe hepatic impairment
  • Known hypersensitivity to rifapentine or isoniazid

Treatment and study plan

Primary outcomes

  1. Favourable Treatment Outcome at 12 Months (DS-TB Cohorts)

    Time frame: 12 months from treatment initiation

    Proportion of patients with drug-susceptible tuberculosis who achieve a favourable treatment outcome, defined as "cured" or "treatment completed" without recurrence, within 12 months of treatment initiation. Compared between 2HPMZ/2HPM and standard 2HRZE/4HR cohorts.

Secondary outcomes

  1. Cumulative Incidence of Serious Adverse Events

    Time frame: Up to 4 months

    Cumulative incidence rate, timing of onset, severity, and outcomes of all serious adverse events recorded during treatment in the 2HPMZ/2HPM and 1HP cohorts. Treatment duration is up to 4 months for 2HPMZ/2HPM and up to 1 month for 1HP.

  2. Treatment completion rate

    Time frame: Up to 4 months

    Percentage of participants who complete the full assigned regimen (2HPMZ/2HPM or 1HP) without premature discontinuation, measured from treatment initiation through the end of the assigned regimen.

Other outcomes

  1. Programmatic operability

    Time frame: Up to 4 months

    Descriptive documentation of reasons for treatment non-initiation or premature discontinuation across the 2HPMZ/2HPM and 1HP cohorts, assessed from treatment initiation through the end of the assigned regimen.

Study contacts

Contact information is provided by the study sponsor or research team.

Elmira Gurbanova, MD, PhD

CONTACT

[email protected]

+37256144656

Gulnaz Musabekova, MD

CONTACT

[email protected]

+77776814267

Sponsors and collaborators

Lead sponsor

Public Union "Kazakhstan Association of Phthisiopulmonologists"

Other

Collaborators

  • The Western-Eastern European Partnership Initiative on HIV, Viral Hepatitis and TB

Registry information

Official study title

Research on Evaluating Rifapentine-Based Shorter Regimens for Tuberculosis and Tuberculosis Infection Among People Living With and Without HIV in Programmatic Settings in Kazakhstan (RIFA-REAL)

Acronym: RIFA-REAL

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jun 25, 2026
Registry last updated
Jun 25, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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