Evidence map›Paper›PMID 40155063›Full record

Trial reportThe Journal of antimicrobial chemotherapy2025

Population pharmacokinetics and exposure-response relationship of the antituberculosis drug BTZ-043.

Simon E Koele, Norbert Heinrich, Veronique R De Jager, Julia Dreisbach, Patrick P J Phillips, Petra Gross-Demel, Rodney Dawson, Kim Narunsky, Leticia M Wildner, Timothy D Mchugh and 5 more

Abstract readRandomized Controlled TrialClinical Trial, Phase IClinical Trial, Phase II
In one paragraph

Trial report in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Simon E KoeleDepartment of Pharmacy, Radboud Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-7011-667X
Norbert HeinrichInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU, Munich, Germany.
Veronique R De JagerTASK, Cape Town, South Africa.
Julia DreisbachInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU, Munich, Germany.ORCID 0000-0001-6625-9857
Patrick P J PhillipsUCSF Center for Tuberculosis, University of California San Francisco, San Francisco, USA.
Petra Gross-DemelInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU, Munich, Germany.
Rodney DawsonDepartment of Medicine, University of Cape Town Lung Institute, Cape Town, South Africa.
Kim NarunskyDepartment of Medicine, University of Cape Town Lung Institute, Cape Town, South Africa.
Leticia M WildnerUCL Centre for Clinical Microbiology, University College London, London, UK.
Timothy D MchughUCL Centre for Clinical Microbiology, University College London, London, UK.
Lindsey H M Te BrakeDepartment of Pharmacy, Radboud Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
Andreas H DiaconTASK, Cape Town, South Africa.
Rob E AarnoutseDepartment of Pharmacy, Radboud Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
Michael HoelscherInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU, Munich, Germany.ORCID 0000-0002-7642-1835
Elin M SvenssonDepartment of Pharmacy, Radboud Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.

Funding

Bavarian Ministry for Science and the ArtsDutch Research CouncilGerman Center for Infection ResearchGerman Ministry for Education and Research 01KA1701InfectControl 03ZZ0803ANederlandse Organisatie voor Wetenschappelijk OnderzoekPanACEA-TB consortium TRIA2015-1102Swiss State Secretariat for Education, Research, and InnovationVeni project 09150161910052
6 · The paper itself

Abstract

introductionBTZ-043 is a first-in-class benzothiazinone for the treatment of TB with demonstrated early bactericidal activity. BTZ-043 is metabolized into two major metabolites: M1 and M2. The aim of this study was to characterize the pharmacokinetics (PK) and early exposure-response (pharmacokinetic/pharmacodynamic, PK/PD) relationship for BTZ-043.

methodsA population PK/PD model for BTZ-043 and its metabolites was developed using data from a sequential Phase 1b/2a, randomized, controlled clinical trial in participants with pulmonary TB. BTZ-043 was administered in daily doses ranging from 250 to 1750 mg over 14 days. The decrease in bacterial load was determined by culture of sputum samples to quantify cfu on solid medium, and time to positivity in liquid medium.

resultsIn total, 77 participants received the experimental treatment. PK were best described by two-compartment disposition models for BTZ-043 and M2, and a one-compartment disposition model for M1. When given without food, the bioavailability was 54% (95% CI: 43%-65%) lower than with food. The decrease in bacterial load was described by a bilinear model with estimated node at 48 h. Participants in the highest dose group in Stage 2 (1000 mg) had a 2-fold faster decrease in mycobacterial load during the initial 2 days compared with participants in the lowest dose group (250 mg), driven by an Emax relationship to the BTZ-043total exposure (BTZ-043 + M2).

conclusionsWe characterized the population PK/PD of BTZ-043 in trial participants with pulmonary TB. An exposure-response relationship was only apparent for the first 2 days on treatment, indicating the need for further dose-finding studies.

Indexed as

Antitubercular AgentsThiazinesTuberculosis, PulmonaryAdolescentAdultAgedBacterial LoadFemaleHumansMaleMiddle AgedMycobacterium tuberculosisSputumTreatment OutcomeYoung AdultAntitubercular AgentsThiazines

Identifiers

PMID40155063
PMCPMC12046392

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.