Ceftriaxone for Post-Treatment Lyme Disease

Study Purpose

Lyme disease is a public health crisis in the US. It is estimated that over 400,000 cases occur every year with 10-20% of those infected going on to develop Post-Treatment Lyme disease Syndrome (PTLDS). The goal of this study is to investigate if giving Ceftriaxone every 5 days for about 6 weeks kills the organism that produces persistent Lyme infection. Enrolled participants will be randomized 1:1 receiving either pulse-dosed ceftriaxone or placebo [dextrose (5% in water), (D5W)], intravenously. Participants will be evaluated at each of the study visits, and then in a follow-up phase out to 12 months. They will be unblinded at 6 months and those randomized to the placebo group will be offered pulse-dosed ceftriaxone on the same schedule as those randomized to the drug group. All patients will be followed up for a total of 12 months post treatment initiation.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years - 75 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Age 18 to 75 years at the time of consent.
  • - Ability and willingness to sign informed consent.
  • - Available for the study period.
  • - Must have met the definition of a prior well-defined or probable Lyme disease infection, AND meet the definition of PTLDS.
  • - Provide consent for release of medical history records and photographs from primary care physician, college or university, urgent care or emergency room visit.
  • - Have a level of fatigue that interferes with their ability to function in their job, schooling, or other social/personal activities (FSS score of 4 or higher) - Subjects will need to have been off of antibiotics (those standard antibiotics used to target Lyme disease to include doxycycline, amoxicillin, cefuroxime, azithromycin, ceftriaxone or penicillin) for at least 6 weeks prior to study enrollment and be willing to remain off of any outside antibiotics during the duration of the treatment component of the study.

Exclusion Criteria:

  • - Female: pregnant or lactating.
  • - Women who intend to become pregnant during the treatment study period (approximately 45 days) - Patients with a diagnosis of Lyme disease based on only a positive Lyme IgM immunoblot.
  • - A history of cephalosporin allergy or significant intolerance.
  • - Lyme related symptoms that have been present for greater than 10 years.
  • - Blood tests confirming infection with human immunodeficiency virus- 1 (HIV-1), hepatitis C, hepatitis B (assessed by HbsAg) virus.
Note: Subjects who have well controlled HIV, who are on ART with a CD4 count of >200 will be allowed to participate.
  • - Diagnosis with Bipolar Disorder or Schizophrenia, hospitalization in the past year for a mental health disorder, or any other psychiatric condition to include any finding of increased suicide risk per the CSSRS scale (score 6 or greater), which in the opinion of the investigator prevents the subject from participating in the study.
  • - Known concurrent rheumatologic or similar disease thought to interfere with study participation or confound results at the discretion of the investigator.
These may include but are not limited to rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome, scleroderma, psoriasis, fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, or obstructive sleep apnea.
  • - Hives, shortness of breath, swelling of the lips or throat, or hospitalization related to a previous treatment with a cephalosporin antibiotic, or severe allergic reaction to penicillins (e.g. anaphylaxis or severe rash with Stevens Johnson syndrome or similar) - Planned travel during the study period that would interfere with the ability to complete all study visits (this can be a temporary exclusion with plan to schedule enrollment during a window of time during which they could attend their study visits) - Significant screening physical examination abnormalities or chronic medical condition that in the opinion of the investigator may impact subject safety.
  • - Participation (active or follow-up phase) or planned participation in another vaccine, drug, or medical device in the 4 weeks prior to this trial or during the trial.
  • - Prior history of Clostridium difficile infection.
  • - Unable to comply with study requirements.
- Clinician discretion

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT06785402
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 1/Phase 2
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Hackensack Meridian Health
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Bindu Balani, MD
Principal Investigator Affiliation Hackensack Meridian Health
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other
Overall Status Not yet recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Post-Treatment Lyme Disease Syndrome
Arms & Interventions

Arms

Experimental: Ceftriaxone 2 GM

Administration of IV ceftriaxone or D5W. Subjects will be infused approximately every 5 days (+/- 1 day) over the course of ~6 weeks. Subjects will receive a total of 9 infusions throughout the treatment phase of the study, with the last infusion tentatively scheduled for Day 41 (+/- 3 days).

Placebo Comparator: Placebo

Placebo [dextrose (5% in water), (D5W)] IV following the same infusion schedule as the ceftriaxone arm.

Interventions

Drug: - Ceftriaxone treatment

9 infusions spaced out approximately every 5 days

Drug: - Placebo

D5W (placebo)

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Hackensack University Medical Center, Hackensack, New Jersey

Status

Address

Hackensack University Medical Center

Hackensack, New Jersey, 07601

Site Contact

Bindu Balani, MD

[email protected]

201-487-4088