Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Comparison of Intensive Treatment Regimens and Standard Treatment Regimen for Tuberculous Meningitis: Pharmacokinetics, Pharmacodynamics and Tolerability Study
Brief Summary: Tuberculous meningitis (TBM) is the most lethal form of tuberculosis infection, and is diagnosed in approximately 5-10% of TB patients. The incidence of TBM has increased considerably during the last decade, partly due to the HIV epidemic. Without treatment, virtually all patients with TB meningitis will die. With the current treatment regimens, TBM is fatal in approximately 30-50% of cases, and responsible for severe disability in a similar proportion of survivors.

Worldwide, Indonesia the third highest case load of tuberculosis with an estimated 500,000 new patients / year. Representative data are lacking, but it is clear that TBM is a growing problem. For instance, in Hasan Sadikin Hospital, the top-referral hospital for West Java Province (population 40 million), Indonesia, 40-50 cases of TBM were treated yearly in the late 90's compared to approximately 100 in recent years.

There is very little evidence for the current treatment regimen for TBM, which dates back to the late 60's. Therefore, there is an urgent need to evaluate intensified treatment of TBM in randomized trials. We hypothesize that higher dose rifampicin, moxifloxacin (possibly also at high dose), or both will improve outcome of TBM. To determine the experimental regimen(s) which should be compared with current regimen in phase 3 trials, we want to evaluate pharmacokinetic aspects and toxicity of candidate regimens in a phase 2 clinical trial in 60 patients with TBM in Indonesia.


Options:
A: Arm Label: Standard dose rifampisin; Type: ACTIVE_COMPARATOR; Interventions: Drug: Moxifloxacin | Arm Label: High dose rifampisin; Type: EXPERIMENTAL; Interventions: Drug: Moxifloxacin | Intervention Type: DRUG; Name: Moxifloxacin; Assigned to Arm(s): High dose rifampisin, Standard dose rifampisin
B: Arm Label: TMC207 Stage 1; Type: EXPERIMENTAL; Interventions: Drug: TMC207, Drug: Background regimen (BR) for MDR-TB (multi-drug resistant tuberculosis) | Arm Label: Placebo Stage 1; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo, Drug: Background regimen (BR) for MDR-TB (multi-drug resistant tuberculosis) | Arm Label: TMC207 Stage 2; Type: EXPERIMENTAL; Interventions: Drug: TMC207, Drug: Background regimen (BR) for MDR-TB (multi-drug resistant tuberculosis) | Arm Label: Placebo Stage 2; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo, Drug: Background regimen (BR) for MDR-TB (multi-drug resistant tuberculosis) | Intervention Type: DRUG; Name: TMC207; Assigned to Arm(s): TMC207 Stage 1, TMC207 Stage 2 | Intervention Type: DRUG; Name: Placebo; Assigned to Arm(s): Placebo Stage 1, Placebo Stage 2 | Intervention Type: DRUG; Name: Background regimen (BR) for MDR-TB (multi-drug resistant tuberculosis); Assigned to Arm(s): Placebo Stage 1, Placebo Stage 2, TMC207 Stage 1, TMC207 Stage 2
C: Arm Label: HRZE; Type: ACTIVE_COMPARATOR; Interventions: Drug: isoniazid | Arm Label: MRZE; Type: EXPERIMENTAL; Interventions: Drug: Moxifloxacin (with rifampin, pyrazinamide, and ethambutol) | Intervention Type: DRUG; Name: Moxifloxacin (with rifampin, pyrazinamide, and ethambutol); Assigned to Arm(s): MRZE | Intervention Type: DRUG; Name: isoniazid; Assigned to Arm(s): HRZE
D: Arm Label: TMC207; Type: EXPERIMENTAL; Interventions: Drug: TMC207 | Arm Label: TMC207 and pyrazinamide; Type: EXPERIMENTAL; Interventions: Drug: Pyrazinamide, Drug: TMC207 | Arm Label: PA-824 and pyrazinamide; Type: EXPERIMENTAL; Interventions: Drug: PA-824, Drug: Pyrazinamide | Arm Label: PA-824 and moxifloxacin and pyrazinamide; Type: EXPERIMENTAL; Interventions: Drug: PA-824, Drug: Moxifloxacin | Arm Label: Rifafour e-275 mg; Type: ACTIVE_COMPARATOR; Interventions: Drug: Rifafour | Arm Label: TMC207 and PA-824; Type: EXPERIMENTAL; Interventions: Drug: PA-824, Drug: TMC207 | Intervention Type: DRUG; Name: PA-824; Assigned to Arm(s): PA-824 and moxifloxacin and pyrazinamide, PA-824 and pyrazinamide, TMC207 and PA-824 | Intervention Type: DRUG; Name: Pyrazinamide; Assigned to Arm(s): PA-824 and pyrazinamide, TMC207 and pyrazinamide | Intervention Type: DRUG; Name: TMC207; Assigned to Arm(s): TMC207, TMC207 and PA-824, TMC207 and pyrazinamide | Intervention Type: DRUG; Name: Rifafour; Assigned to Arm(s): Rifafour e-275 mg | Intervention Type: DRUG; Name: Moxifloxacin; Assigned to Arm(s): PA-824 and moxifloxacin and pyrazinamide

Answer: A