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Randomised controlled trial to evaluate the effectiveness of using the RD-1-based C-Tb skin test as a replacement for blood-based interferon-γ release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: RID-TB:Dx study protocol

INTRODUCTION: The predictive utility for incident tuberculosis (TB) of the purified protein derivative tuberculin skin test and region of difference 1 (RD1)-based interferon-gamma release assays (IGRA) is comparable; and either is recommended to test for latent TB infection (LTBI). Despite associate...

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Autores principales: Rangaka, Molebogeng X, Hamada, Yohhei, Duong, Trinh, Bern, Henry, Calvert, Joanna, Francis, Marie, Clarke, Amy Louise, Ghanouni, Alex, Hack, Vanessa, Owen-Powell, Ellen, Surey, Julian, Sanders, Karen, Booth, Helen L, Crook, Angela, Griffiths, Chris, Horne, Robert, Kunst, Heinke, Lipman, Marc, Mandelbaum, Mike, White, Peter J, Whiting, Penny, Zenner, Dominik, Abubakar, Ibrahim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718463/
http://dx.doi.org/10.1136/bmjopen-2021-050595
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author Rangaka, Molebogeng X
Hamada, Yohhei
Duong, Trinh
Bern, Henry
Calvert, Joanna
Francis, Marie
Clarke, Amy Louise
Ghanouni, Alex
Hack, Vanessa
Owen-Powell, Ellen
Surey, Julian
Sanders, Karen
Booth, Helen L
Crook, Angela
Griffiths, Chris
Horne, Robert
Kunst, Heinke
Lipman, Marc
Mandelbaum, Mike
White, Peter J
Whiting, Penny
Zenner, Dominik
Abubakar, Ibrahim
author_facet Rangaka, Molebogeng X
Hamada, Yohhei
Duong, Trinh
Bern, Henry
Calvert, Joanna
Francis, Marie
Clarke, Amy Louise
Ghanouni, Alex
Hack, Vanessa
Owen-Powell, Ellen
Surey, Julian
Sanders, Karen
Booth, Helen L
Crook, Angela
Griffiths, Chris
Horne, Robert
Kunst, Heinke
Lipman, Marc
Mandelbaum, Mike
White, Peter J
Whiting, Penny
Zenner, Dominik
Abubakar, Ibrahim
author_sort Rangaka, Molebogeng X
collection PubMed
description INTRODUCTION: The predictive utility for incident tuberculosis (TB) of the purified protein derivative tuberculin skin test and region of difference 1 (RD1)-based interferon-gamma release assays (IGRA) is comparable; and either is recommended to test for latent TB infection (LTBI). Despite associated high costs of IGRA, sites participating in LTBI screening in many high-income settings pragmatically favour IGRA due to its higher specificity and simpler logistics. A new RD1-based skin test, C-Tb, could offer an acceptable and as accurate, cheaper alternative to IGRA. Evaluating the impact of C-Tb on process and patient-related outcomes would provide important information to help guide its use in LTBI testing strategies. METHODS AND ANALYSIS: This is a pragmatic multicentre, open-label, non-inferiority, randomised controlled trial. The trial will assess the initiation of LTBI treatment following a positive result of the randomised test as the primary outcome. Participants will be randomised to receive the C-Tb test (intervention) or IGRA (usual care, control) for initiation of treatment. We will enrol 1530 participants in England aged≥16 years who are eligible for LTBI testing and treatment according to UK guidance. In the C-Tb arm, skin induration will be assessed 2–3 days after intradermal injection and measured in millimetres of induration. Results of IGRA will be obtained in line with standard practice. Behavioural studies will explore people’s experiences, perspectives and preferences of LTBI testing and treatment. Economic analysis will estimate cost-effectiveness of changes to the diagnostic algorithm for LTBI. The protocol was developed with Patient and Public Involvement (PPI), which will continue throughout the trial. ETHICS AND DISSEMINATION: Ethics approval has been obtained from The NHS Health Research Authority (269485). We will share results of the trial in peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER: EudraCT 2019-002592-34; ISRCTN17936038.
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spelling pubmed-87184632022-01-12 Randomised controlled trial to evaluate the effectiveness of using the RD-1-based C-Tb skin test as a replacement for blood-based interferon-γ release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: RID-TB:Dx study protocol Rangaka, Molebogeng X Hamada, Yohhei Duong, Trinh Bern, Henry Calvert, Joanna Francis, Marie Clarke, Amy Louise Ghanouni, Alex Hack, Vanessa Owen-Powell, Ellen Surey, Julian Sanders, Karen Booth, Helen L Crook, Angela Griffiths, Chris Horne, Robert Kunst, Heinke Lipman, Marc Mandelbaum, Mike White, Peter J Whiting, Penny Zenner, Dominik Abubakar, Ibrahim BMJ Open Infectious Diseases INTRODUCTION: The predictive utility for incident tuberculosis (TB) of the purified protein derivative tuberculin skin test and region of difference 1 (RD1)-based interferon-gamma release assays (IGRA) is comparable; and either is recommended to test for latent TB infection (LTBI). Despite associated high costs of IGRA, sites participating in LTBI screening in many high-income settings pragmatically favour IGRA due to its higher specificity and simpler logistics. A new RD1-based skin test, C-Tb, could offer an acceptable and as accurate, cheaper alternative to IGRA. Evaluating the impact of C-Tb on process and patient-related outcomes would provide important information to help guide its use in LTBI testing strategies. METHODS AND ANALYSIS: This is a pragmatic multicentre, open-label, non-inferiority, randomised controlled trial. The trial will assess the initiation of LTBI treatment following a positive result of the randomised test as the primary outcome. Participants will be randomised to receive the C-Tb test (intervention) or IGRA (usual care, control) for initiation of treatment. We will enrol 1530 participants in England aged≥16 years who are eligible for LTBI testing and treatment according to UK guidance. In the C-Tb arm, skin induration will be assessed 2–3 days after intradermal injection and measured in millimetres of induration. Results of IGRA will be obtained in line with standard practice. Behavioural studies will explore people’s experiences, perspectives and preferences of LTBI testing and treatment. Economic analysis will estimate cost-effectiveness of changes to the diagnostic algorithm for LTBI. The protocol was developed with Patient and Public Involvement (PPI), which will continue throughout the trial. ETHICS AND DISSEMINATION: Ethics approval has been obtained from The NHS Health Research Authority (269485). We will share results of the trial in peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER: EudraCT 2019-002592-34; ISRCTN17936038. BMJ Publishing Group 2021-12-30 /pmc/articles/PMC8718463/ http://dx.doi.org/10.1136/bmjopen-2021-050595 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Infectious Diseases
Rangaka, Molebogeng X
Hamada, Yohhei
Duong, Trinh
Bern, Henry
Calvert, Joanna
Francis, Marie
Clarke, Amy Louise
Ghanouni, Alex
Hack, Vanessa
Owen-Powell, Ellen
Surey, Julian
Sanders, Karen
Booth, Helen L
Crook, Angela
Griffiths, Chris
Horne, Robert
Kunst, Heinke
Lipman, Marc
Mandelbaum, Mike
White, Peter J
Whiting, Penny
Zenner, Dominik
Abubakar, Ibrahim
Randomised controlled trial to evaluate the effectiveness of using the RD-1-based C-Tb skin test as a replacement for blood-based interferon-γ release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: RID-TB:Dx study protocol
title Randomised controlled trial to evaluate the effectiveness of using the RD-1-based C-Tb skin test as a replacement for blood-based interferon-γ release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: RID-TB:Dx study protocol
title_full Randomised controlled trial to evaluate the effectiveness of using the RD-1-based C-Tb skin test as a replacement for blood-based interferon-γ release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: RID-TB:Dx study protocol
title_fullStr Randomised controlled trial to evaluate the effectiveness of using the RD-1-based C-Tb skin test as a replacement for blood-based interferon-γ release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: RID-TB:Dx study protocol
title_full_unstemmed Randomised controlled trial to evaluate the effectiveness of using the RD-1-based C-Tb skin test as a replacement for blood-based interferon-γ release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: RID-TB:Dx study protocol
title_short Randomised controlled trial to evaluate the effectiveness of using the RD-1-based C-Tb skin test as a replacement for blood-based interferon-γ release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: RID-TB:Dx study protocol
title_sort randomised controlled trial to evaluate the effectiveness of using the rd-1-based c-tb skin test as a replacement for blood-based interferon-γ release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: rid-tb:dx study protocol
topic Infectious Diseases
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718463/
http://dx.doi.org/10.1136/bmjopen-2021-050595
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