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Bedaquiline

Phase 3

Pulmonary Tuberculosis | Small molecule | Infectious Disease |Third Harmonic Bio, Inc.|Last Updated: Dec 1, 2025

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedACTIVE_CONTROLLEDBiomarker
Total Trials1
Total Enrollment610
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT06905522A PAN-USR TB Multi-Center TrialPHASE3 RECRUITING 610Jun 18, 2025Dec 1, 2029Dec 1, 20253 China
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Study Endpoints
Primary Endpoints
Unfavorable outcomes
12 months (52 weeks)

Percentage of patients with unfavorable outcomes (failure, treatment interruption, death, loss to follow-up, re-treatment, recurrence) at 12 months (52 weeks) after randomization

Safety
2 months (9 weeks)

Percentage of patients who have treatment interruption due to any reason or died within 2 months (9 weeks) after randomization

Secondary Endpoints
Sputum culture conversion rate
2 months (9 weeks) after randomization
Unfavorable outcomes (short-term)
6 months (26 weeks) after randomization
Unfavorable outcomes (mid-term)
18 months (78 weeks) after randomization
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Drug-susceptible TB (A1)EXPERIMENTAL2 months (9 weeks) BLSZ regimen: The treatment involves the use of bedaquiline (B), linezolid (L), sitafloxacin (S), and pyrazinamide (Z) throughout the entire process. At the end of 2 months (9 weeks) of treatment, if the sputum smear is still positive or if clinical symptoms have not improved, the treatment duration can be extended to 13 weeks. After the extended treatment period (3 months or 13 weeks), if the sputum smear remains positive or if clinical symptoms have not been relieved, the patient should be switched to the standard treatment regimen, and the subject should be withdrawn from the study.
Drug-resistant TB (A2)EXPERIMENTAL2 months (9 weeks) BLSZ regimen: The treatment involves the use of bedaquiline (B), linezolid (L), sitafloxacin (S), and pyrazinamide (Z) throughout the entire process. At the end of 2 months (9 weeks) of treatment, if the sputum smear is still positive or if clinical symptoms have not improved, the treatment duration can be extended to 13 weeks. After the extended treatment period (3 months or 13 weeks), if the sputum smear remains positive or if clinical symptoms have not been relieved, the patient should be switched to the standard treatment regimen, and the subject should be withdrawn from the study.
Drug-susceptible TB (B)ACTIVE_COMPARATOR2HRZE/4HR (26 weeks): Four drugs-isoniazid (H), rifampicin (R), pyrazinamide (Z), and ethambutol (E)-are used during the first 2 months of the intensive phase. This is followed by 4 months of consolidation treatment, during which only isoniazid and rifampicin are used.
Drug-resistant TB (C)ACTIVE_COMPARATOR6 months (26 weeks) of BPaLM: The treatment involves the use of bedaquiline (B), pretomanid (Pa), linezolid (L), and moxifloxacin (M) throughout the entire course. If the sputum culture remains positive at 4 months, or if clinical symptoms are not relieved by 6 months, or if chest CT results show worsening at 6 months, the treatment may be extended to 9 months. If the patient chooses to withdraw from the study at 6 months, they are allowed to do so.
Interventions
NameTypeDescription
Bedaquiline (B)DRUGThe initial dose of bedaquiline is 400 mg daily for 2 weeks, followed by 200 mg three times a week.
Sitafloxacin (S)DRUG200mg once daily
Linezolid (L)DRUG600mg once daily
Pyrazinamide (Z)DRUG20-30 mg/kg/day; 1000 mg for patients weighing \<50 kg, 1500 mg for patients weighing ≥50 kg but \<75 kg, and 2000 mg for patients weighing ≥75 kg.
Isoniazid (H)DRUG4-6 mg/kg once daily, 300 mg once daily
Rifampicin (R)DRUG8-12 mg/kg once daily, 450 mg for patients weighing \<50 kg, 600 mg for patients weighing ≥50 kg but \<75 kg, and 750 mg for patients weighing ≥75 kg.
Ethambutol (E)DRUG15-25 mg/kg once daily, 750 mg once daily
Moxifloxacin (M)DRUG400mg once daily
Pretomanid (Pa)DRUG200mg once daily
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Eligibility Criteria
Age Range18 Years — 65 Years
SexALL
Healthy VolunteersNo
Study Sites3

Inclusion criteria: 1. Age range from 18 to 65 years old, regardless of gender; 2. Clinical symptoms and/or pulmonary imaging (chest X-ray or chest CT) support the diagnosis of active pulmonary tuberculosis; 3. Microbiological testing (molecular or phenotypic) confirms the presence of Mycobacterium...

Countries:China
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Recent Changes (Last 90 Days)
LOWMay 24, 2026NCT06905522studyFirstPostDate: changed