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Bedaquiline

Phase 2

Leprosy, Multibacillary | Small molecule | Infectious Disease |Johnson & Johnson|Last Updated: Jul 6, 2026

Target and mechanism

ModalitySmall molecule

Also known as Bedaquiline (TMC207)

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLED
Total Trials1
Total Enrollment11

FDA Designations

No designations recorded

Clinical trial landscape

Bedaquiline · 5 trials · 4 indications

Phase 2 3Phase 1 2
NCT04630145A Study of Bedaquiline Administered as Part of a Treatment Regimen With Clarithromycin and Ethambutol in Adult Patients With Treatment-refractory Mycobacterium Avium Complex-lung Disease (MAC-LD)Treatment-refractory Mycobacterium Avium Complex-lung Disease (MAC-LD)
COMPLETED129 Analytics
NCT03384641A Study to Evaluate the Efficacy and Safety of Bedaquiline (TMC207) in Participants With Multibacillary LeprosyLeprosy, Multibacillary
COMPLETED11 Analytics
NCT02354014Pharmacokinetic Study to Evaluate Anti-mycobacterial Activity of TMC207 in Combination With Background Regimen (BR) of Multidrug Resistant Tuberculosis (MDR-TB) Medications for Treatment of Children/Adolescents With Pulmonary MDR-TBTuberculosis, Multidrug-Resistant
RECRUITING60 Analytics
PHASE2COMPLETED
A Study of Bedaquiline Administered as Part of a Treatment Regimen With Clarithromycin and Ethambutol in Adult Patients With Treatment-refractory Mycobacterium Avium Complex-lung Disease (MAC-LD)
Treatment-refractory Mycobacterium Avium Complex-lung Disease (MAC-LD)Unlock trial analytics
PHASE2COMPLETED
A Study to Evaluate the Efficacy and Safety of Bedaquiline (TMC207) in Participants With Multibacillary Leprosy
Leprosy, MultibacillaryUnlock trial analytics
PHASE2RECRUITING
Pharmacokinetic Study to Evaluate Anti-mycobacterial Activity of TMC207 in Combination With Background Regimen (BR) of Multidrug Resistant Tuberculosis (MDR-TB) Medications for Treatment of Children/Adolescents With Pulmonary MDR-TB
Tuberculosis, Multidrug-ResistantUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Sputum Culture Conversion in Mycobacteria Growth Indicator Tube (MGIT) at Week 24
At Week 24

Number of participants with sputum culture conversion in MGIT at Week 24 was reported. Sputum culture conversion was defined as 3 consecutive negative sputum cultures taken at least 25 days apart.

Change from Baseline in the Odds of Mycobacterium leprae (M. leprae) Growth in Mouse Footpads Following 8 Weeks of Treatment with Bedaquiline
Baseline up to Week 8

Change from baseline in the odds of M. leprae growth in mouse footpads will be evaluated. M. leprae bacilli will be inoculated in footpads of mice, according to the method of Shepard. M. leprae growth will be determined by technologists trained and experienced in mouse footpad procedures, at 1 year after infection (or at mouse death or humane endpoint, if it occurs greater than or equal to \[\>=\] 6 months after footpad inoculation). The number of footpads with positive growth (\>=10\^5 M. leprae) will be counted and used to determine the odds of bacterial growth.

Number of Participants With Adverse Events (AEs) or Serious Adverse Events (SAEs)
Cohort 1 to 3 = up to 120 Weeks and Cohort 4 = up to 88 Weeks

An AE is any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.

Maximum Plasma Concentration (Cmax)
Week 2 and 12

The Cmax is the maximum plasma concentration.

Time to Reach Maximum Plasma Concentration (Tmax)
Week 2 and 12

The Tmax is time to reach the maximum plasma concentration.

Minimum Plasma Concentration (Cmin)
Week 2, 12 and 24

The Cmin is the minimum plasma concentration.

Area Under the Plasma Concentration-time Curve From the Time of Dose Administration up to X Hours (AUCtime-h)
Week 2, 12 and 24

AUCtime-h is the area under the plasma concentration-time curve from the time of dose administration up to X hours.

Elimination Half-life (t1/2)
For Cohorts 1 to 3: Day 1, Weeks 2, 4,6,8,12,16,20,24,28,32,40,48,60,72,84,96,108,120; For Cohort 4: Day 1, Weeks 2,12, 24, 32, 48, 88

Elimination half-life (t \[1/2\]) is associated with the terminal slope (lambda \[z\]) of the semi logarithmic drug concentration-time curve, calculated as 0.693/lambda(z). Lambda(z) is first-order rate constant associated with the terminal portion of the curve, determined as the negative slope of the terminal log-linear phase of the drug concentration-time curve.

Area Under the Plasma Concentration-time Curve From the Time of Dose Administration up to 168 Hours [AUC168h]
Week 12 and 24

AUC168h is the area under the plasma concentration-time curve from the time of dose administration up to 168 Hours.

Volume of Distribution (Vd)
For Cohorts 1 to 3: Day 1, Weeks 2, 4,6,8,12,16,20,24,28,32,40,48,60,72,84,96,108,120; For Cohort 4: Day 1, Weeks 2,12, 24, 32, 48, 88

Volume of distribution is calculated as Dose divided by Lambda(z) multiplied by AUC(infinity). The AUC (infinity) is the area under the plasma concentration-time curve from time zero to infinite time.

Apparent Clearance (CL)
For Cohorts 1 to 3: Day 1, Weeks 2, 4,6,8,12,16,20,24,28,32,40,48,60,72,84,96,108,120; For Cohort 4: Day 1, Weeks 2,12, 24, 32, 48, 88

Apparent clearance is calculated as Dose/AUC (infinity). The AUC (infinity) is the area under the plasma concentration-time curve from time zero to infinite time.

Maximum Observed Analyte Concentration (Cmax) of Bedaquiline
Predose, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, 72, 120, 168, 216, 264, 336, 504, and 672 hours postdose

Cmax is the maximum observed analyte concentration.

Area Under the Analyte Concentration-time Curve from Time 0 to 72 Hours (AUC [0-72 hours]) of Bedaquiline
Predose, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, and 72 hours postdose

AUC (0-72 hours) is area under the analyte concentration-time curve from time 0 to 72 hours, calculated by linear-linear trapezoidal summation.

Area Under the Concentration-time Curve from Time Zero to the Last Measurable Concentration (AUC [0-last]) of Bedaquiline
Predose, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, 72, 120, 168, 216, 264, 336, 504, and 672 hours postdose

AUC (0-last) is area under the analyte concentration-time curve from time zero to the time of the last measurable (non-below quantification limit) concentration, calculated by linear-linear trapezoidal summation.

Area Under the Concentration-time Curve from Time Zero to Infinity (AUC [0-infinity]) of Bedaquiline
Predose, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, 72, 120, 168, 216, 264, 336, 504, and 672 hours postdose

AUC (0-infinity) is the area under the analyte concentration-time curve from time zero to infinity time, calculated as the sum of AUC (0-last) and C(last)/lambda(z); wherein AUC (0-last) is area under the plasma concentration-time curve from time zero to last measurable concentration, C(last) is the last observed measurable concentration, and lambda(z) is apparent terminal elimination rate constant.

Maximum Observed Analyte Concentration (Cmax) of Bedaquiline and its Metabolite (M2)
Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, 72, 120, 168, and 240 hours Post-dose

Cmax is the maximum observed analyte concentration.

Minimum Observed Analyte Concentration (Cmin) of Bedaquiline and its Metabolite (M2)
Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, 72, 120, 168, and 240 hours Post-dose

Cmin is the minimum observed analyte concentration.

Area Under the Analyte Concentration versus Time Curve (AUC) From Time of Administration up to 72 Hours Post Dosing (AUC72h) of Bedaquiline and its Metabolite (M2)
Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, and 72 hours Post-dose

AUC72h is the area under the analyte concentration versus time curve (AUC) from time of administration up to 72 hours post dosing, calculated by linear-linear trapezoidal summation.

Area Under the Analyte Concentration versus Time Curve (AUC) From Time of Administration up to 240 Hours Post Dosing (AUC240h) of Bedaquiline and its Metabolite (M2)
Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, 72, 120, 168, and 240 hours Post-dose

AUC240h is the area under the analyte concentration-time curve from time 0 to 240 hours, calculated by linear-linear trapezoidal summation.

Secondary Endpoints

Number of Participants With Sputum Culture Conversion in 7H11 Agar Media at Week 24
At week 24
Change From Baseline in Patient Reported Health Status on Total Score of St. George's Respiratory Questionnaire (SGRQ) at Week 24
Baseline (Day 1), Week 24
Percentage of Participants With Sputum Culture Conversion in MGIT at Week 48
At Week 48
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Group A: Bedaquiline (BDQ) + Clarithromycin (CAM) + Ethambutol (EB)EXPERIMENTALParticipants will receive BDQ 400 milligrams (mg) (4\*100 mg tablets) once daily (qd) from Week 1-2 (loading phase), BDQ 200 mg (2\*100mg tablets) bi-weekly (biw) from Week 3 to 48 (maintenance phase) and CAM 400 mg or 500 mg twice daily (2\*200 mg tablets) along with EB 500-750 mg or 15 mg/kg once a day or maximum daily dose of 1.0 gram for up to Week 48.
Group B: Rifampicin (RFP) or Rifabutin (RBT) + CAM + EBACTIVE_COMPARATORParticipants will receive maximum of 4 capsules of RFP 450 mg daily (or maximum daily dose of 600 mg), CAM 400 mg or 500 mg (2\*200 mg tablets) twice a day along with EB 500-750 mg daily or 15 mg/kg once a day or maximum daily dose of 1.0 gram for up to Week 48, followed by 2 capsules of RBT 300 mg or 150 mg once a day.
BedaquilineEXPERIMENTALParticipants will receive bedaquiline 200 (milligram) mg (2\*100 mg tablets) once daily for 2 weeks followed by 100 mg tablet three times a week (tiw) for 6 weeks with at least 48 hours between doses.
Bedaquiline (TMC207)/Background Regimen (BR)EXPERIMENTALThere will be 4 age-based cohorts. Participants will be enrolled concurrently in Cohorts 1 and 2 followed by sequential enrollment of Cohorts 3, 4. Cohort 1: \>= 12 to \< 18 years: bedaquiline (TMC207) tablet orally as 400 mg, once daily(qd),for first 2 weeks, followed by bedaquiline (TMC207), 200 mg 3 times per week (tiw) for 22 weeks; Cohort 2: \>=5 to \<12 years: bedaquiline (TMC207) tablet given orally as 200 mg, qd, for first 2 weeks, followed by bedaquiline (TMC207) 100 mg, tiw for 22 weeks. Cohort 3: \>=2 to \<5 years: bedaquiline (TMC207) 8 milligram per kilogram (mg/kg) qd for the first 2 weeks, followed by bedaquiline (TMC207) 4 mg/kg tiw for 22 weeks. Cohort 4: 0 months to \<2 years: bedaquiline (TMC207) doses will be selected as per weight band and age group. Bedaquiline (TMC207) will be given in combination with Background Regimen for Multidrug Resistant Tuberculosis (MDR-TB) according to WHO/national tuberculosis program (NTP) guidelines/current standard of care.
Treatment Sequence BAEEXPERIMENTALParticipants will receive a single dose of bedaquiline in 3 subsequent sessions as bedaquiline oral test tablet 1 under fasted condition (Treatment B) in period 1, followed by bedaquiline oral reference tablet under fasted condition (Treatment A) in period 2, thereafter will receive bedaquiline oral test tablet 1 under fed condition (Treatment E) in period 3. Each treatment period will be separated with a washout period of at least 28 days.
Treatment Sequence CAFEXPERIMENTALParticipants will receive a single dose of bedaquiline in 3 subsequent sessions as bedaquiline oral test tablet 2 under fasted condition (Treatment C) in period 1, followed by bedaquiline oral reference tablet under fasted condition (Treatment A) in period 2, thereafter will receive bedaquiline oral test tablet II under fed condition (Treatment F) in period 3. Each treatment period will be separated with a washout period of at least 28 days.
Treatment Sequence DAGEXPERIMENTALParticipants will receive a single dose of bedaquiline in 3 subsequent sessions as bedaquiline oral test tablet 3 under fasted condition (Treatment D) in period 1, followed by bedaquiline oral reference tablet under fasted condition (Treatment A) in period 2, thereafter will receive bedaquiline oral test tablet 3 under fed condition (Treatment G) in period 3. Each treatment period will be separated with a washout period of at least 28 days.
Treatment Sequence ABEEXPERIMENTALParticipants will receive a single dose of bedaquiline in 3 subsequent sessions as bedaquiline oral reference tablet under fasted condition (Treatment A) in period 1, followed by bedaquiline oral test tablet 1 under fasted condition (Treatment B) in period 2, thereafter will receive bedaquiline oral test tablet 1 under fed condition (Treatment E) in period 3. Each treatment period will be separated with a washout period of at least 28 days.
Treatment Sequence ACFEXPERIMENTALParticipants will receive a single dose of bedaquiline in 3 subsequent sessions as bedaquiline oral reference tablet under fasted condition (Treatment A) in period 1, followed by bedaquiline oral test tablet 2 under fasted condition (Treatment C) in period 2, thereafter will receive bedaquiline oral test tablet 2 under fed condition (Treatment F) in period 3. Each treatment period will be separated with a washout period of at least 28 days.
Treatment Sequence ADGEXPERIMENTALParticipants will receive a single dose of bedaquiline in 3 subsequent sessions as bedaquiline oral reference tablet under fasted condition (Treatment A) in period 1, followed by bedaquiline oral test tablet 3 under fasted condition (Treatment D) in period 2, thereafter will receive bedaquiline oral test tablet 3 under fed condition (Treatment G) in period 3. Each treatment period will be separated with a washout period of at least 28 days.
Treatment Sequence 1: Bedaquiline and ClarithromycinEXPERIMENTALParticipants will receive bedaquiline on Day 1 in Period 1, followed by clarithromycin on Days 1-14 and bedaquiline on Day 5 in Period 2. There will be washout period of at least 28 days starting on Day 1.
Treatment Sequence 2: Clarithromycin and BedaquilineEXPERIMENTALParticipants will receive clarithromycin on Days 1-14 and bedaquiline on Day 5 in Period 1, followed by bedaquiline on Day 1 in Period 2. There will be a washout period of at least 28 days starting after bedaquiline administration on Day 5.

Interventions

NameTypeDescription
BedaquilineDRUGParticipants will receive BDQ tablets only/
ClarithromycinDRUGParticipants will receive CAM 400 or 500 mg twice a day.
EthambutolDRUGParticipants will receive 500 to 750 mg daily (maximum daily dose of 1.0 gram \[g\]) or 15 mg/kg once a day.
RifampicinDRUGParticipants will receive daily dose is 450 mg (maximum 600 mg) RFP capsule once a day.
RifabutinDRUGParticipants will receive daily dose of RBT 300 mg or 150 mg capsules once a day.
Bedaquiline 200 mgDRUGParticipants will receive bedaquiline 200 mg (2\*100 mg tablets) once daily for 2 weeks followed by 100 mg tablet tiw for 6 weeks with at least 48 hours between doses.
Bedaquiline (TMC207)DRUGBedaquiline (TMC207) oral tablet adult formulation (containing 100 mg bedaquiline (TMC207) per tablet) administered as 400 milligram (mg), once daily, for the first 2 weeks, followed by bedaquiline 200 mg 3 times per week with intakes at least 2 days (48 hours) apart for 22 weeks in cohort 1. Cohort 2, 3 and 4 will receive an age appropriate oral tablet formulation containing 20mg bedaquiline . Bedaquiline tablet administered orally as 200 mg, once daily, for the first 2 weeks, followed by bedaquiline 100 mg 3 times per week with intakes at least 2 days (48 hours) apart for 22 weeks in cohort 2. In Cohort 3, dose of bedaquiline 8 mg/kg qd for the first 2 weeks, followed by bedaquiline 4 mg/kg times weekly (TIW) with intakes at least 2 days (48 hours) apart for 22 weeks will be administered. In cohort 4, bedaquiline (TMC207) qd for the first 2 weeks, followed by bedaquiline TIW with intakes at least 2 days (48 hours) apart for 22 weeks.
Background Regimen (BR)DRUGBackground Regimen (BR) of Multidrug Resistant Tuberculosis (MDR-TB) medications will be dosed according to World Health Organization (WHO) guidelines, National Tuberculosis Program (NTP) guidelines and current standard of care at the site.
Bedaquiline (Test formulation)DRUGParticipants will receive bedaquiline orally.
Bedaquiline (Reference formulation)DRUGParticipants will receive bedaquiline orally.
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Eligibility Criteria

Age Range20 Years to 79 Years
SexALL
Healthy VolunteersNo
Study Sites55

Inclusion Criteria: * Has body weight greater than or equal to (\>=) 40 kilograms (kg) at screening and on Day 1 * Has radiological evidence consistent with nontuberculous mycobacterial lung disease (NTM-LD) based on a chest Computed Tomography (CT) scan taken within 6 months prior to screening or ...

Countries:JapanSouth KoreaTaiwanBrazilMozambiquePhilippinesRussiaSouth AfricaUgandaUkraineBelgium
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Recent Changes (Last 90 Days)

LOWJul 6, 2026NCT02354014lastUpdatePostDate: changed
LOWJul 6, 2026NCT02354014lastUpdatePostDate: changed

Frequently asked questions about Bedaquiline

What is Bedaquiline used for?

Bedaquiline is an investigational small molecule being studied for tuberculosis, multidrug-resistant tuberculosis, multibacillary leprosy, and treatment-refractory Mycobacterium Avium Complex-lung disease (MAC-LD). It has also been evaluated in healthy adult participants in clinical pharmacology studies.

Who makes Bedaquiline?

Bedaquiline is being developed by Johnson & Johnson, a company traded on the New York Stock Exchange under the ticker JNJ.

What phase is Bedaquiline in?

Bedaquiline is in clinical development. It has been studied in Phase 1 and Phase 2 trials, including completed studies in multibacillary leprosy, healthy participants, and treatment-refractory MAC-LD. It remains an investigational drug and is not approved for these uses.

What clinical trials is Bedaquiline in?

Bedaquiline has been studied in several clinical trials. NCT03384641 evaluated its efficacy and safety in participants with multibacillary leprosy in Brazil. NCT03800550 and NCT04087759 assessed drug-drug interactions and tablet formulations in healthy adults in Belgium. NCT04630145 studied it with clarithromycin and ethambutol in patients with treatment-refractory MAC-LD in Japan, South Korea, and Taiwan.

Is Bedaquiline the same as TMC207?

Yes, Bedaquiline is also known as TMC207. Both names refer to the same drug candidate being developed by Johnson & Johnson.

What is the development status of Bedaquiline for multidrug-resistant tuberculosis?

Bedaquiline is listed as being studied for multidrug-resistant tuberculosis, but no specific clinical trial data for that indication has been reported. The drug remains investigational and is in clinical development across multiple indications.