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Last Updated: December 18, 2025

CLINICAL TRIALS PROFILE FOR RIFADIN


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All Clinical Trials for RIFADIN

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00439166 ↗ Effects of Doxycycline and Rifampicin on Biomarkers of Alzheimer's Disease in the Cerebrospinal Fluid Completed The Physicians' Services Incorporated Foundation Phase 3 2007-02-01 This study will determine if biomarkers found in the cerebrospinal fluid of people with Alzheimer's disease, are affected by treatment with two common antibiotics, doxycycline and rifampicin, suggesting a disease-modifying effect of those treatments.
NCT00439166 ↗ Effects of Doxycycline and Rifampicin on Biomarkers of Alzheimer's Disease in the Cerebrospinal Fluid Completed Hamilton Health Sciences Corporation Phase 3 2007-02-01 This study will determine if biomarkers found in the cerebrospinal fluid of people with Alzheimer's disease, are affected by treatment with two common antibiotics, doxycycline and rifampicin, suggesting a disease-modifying effect of those treatments.
NCT00621309 ↗ Sulforaphane as an Antagonist to Human PXR-mediated Drug-drug Interactions Completed Fred Hutchinson Cancer Research Center Phase 1 2008-03-01 Adverse drug-drug interactions (DDIs) are responsible for approximately 3% of all hospitalizations in the US, perhaps costing more than $1.3 billion per year. One of the most common causes of DDIs is the when one drug alters the metabolism of another. A key enzyme in the liver and intestine, called "cytochrome P450 3A4 (CYP3A4) is generally considered to be the most important drug metabolizing enzyme. The gene for CYP3A4 can be 'turned on' by the presence of certain other drugs, resulting in much higher levels of CYP3A4 in the liver and intestine. Thus, when a drug that induces CYP3A4 is given with or before another drug that is metabolized by 3A4, a 'drug-drug' interaction occurs because the first drug (the inducer) greatly changes the rate at which the second drug (CYP3A4 substrate) is removed from the body. Many drugs increase CYP3A4 activity by binding to a receptor called the Pregnane-X-Receptor (PXR), which is a major switch that controls the expression of the CYP3A4 gene. Using human liver cells we have demonstrated that sulforaphane (SFN), found in broccoli, can block drugs from activating the PXR receptor, thereby inhibiting the switch that causes CYP3A4 induction. The purpose of this project is to determine if SFN can be used to block adverse DDIs that occur when drugs bind to and activate the PXR receptor and subsequently induce CYP3A4 activity. We will recruit 24 human volunteers to participate in the study. This project will determine whether SFN can prevent the drug Rifampin from binding to PXR and increasing CYP3A4 activity in humans following oral administration of SFN (broccoli sprout extract). The rate of removal of a small dose of the drug midazolam will be used to determine the enzymatic activity of CYP3A4 before and following treatment with Rifampin, in the presence or absence of SFN, since midazolam is only eliminated from the bloodstream by CYP3A4. . We predict that SFN will prevent the increase in midazolam clearance (metabolism) that normally follows treatment with the antibiotic, rifampicin. This research is important because it could potentially lead to a simple, cost-effective way of preventing one of the most common causes of adverse drug-drug interactions that occurs today. For example, rifampicin, which is a cheap and effective antibiotic used to treat TB, cannot be used in HIV/AIDS patients because it increases the metabolism of many of the antiretroviral drugs used to treat HIV/AIDS. TB is a major opportunistic infection in AIDS patients, so this is a serious clinical problem, especially in developing countries where more expensive alternative drug therapies are not available. We hypothesize that co-formulation of rifampicin with SFN could block this drug-drug interaction without altering its efficacy, thereby allowing its use in HIV/AIDS patients infected with TB. This is but one example of numerous drug-drug interactions that occur via this mechanism.
NCT00621309 ↗ Sulforaphane as an Antagonist to Human PXR-mediated Drug-drug Interactions Completed National Institute of General Medical Sciences (NIGMS) Phase 1 2008-03-01 Adverse drug-drug interactions (DDIs) are responsible for approximately 3% of all hospitalizations in the US, perhaps costing more than $1.3 billion per year. One of the most common causes of DDIs is the when one drug alters the metabolism of another. A key enzyme in the liver and intestine, called "cytochrome P450 3A4 (CYP3A4) is generally considered to be the most important drug metabolizing enzyme. The gene for CYP3A4 can be 'turned on' by the presence of certain other drugs, resulting in much higher levels of CYP3A4 in the liver and intestine. Thus, when a drug that induces CYP3A4 is given with or before another drug that is metabolized by 3A4, a 'drug-drug' interaction occurs because the first drug (the inducer) greatly changes the rate at which the second drug (CYP3A4 substrate) is removed from the body. Many drugs increase CYP3A4 activity by binding to a receptor called the Pregnane-X-Receptor (PXR), which is a major switch that controls the expression of the CYP3A4 gene. Using human liver cells we have demonstrated that sulforaphane (SFN), found in broccoli, can block drugs from activating the PXR receptor, thereby inhibiting the switch that causes CYP3A4 induction. The purpose of this project is to determine if SFN can be used to block adverse DDIs that occur when drugs bind to and activate the PXR receptor and subsequently induce CYP3A4 activity. We will recruit 24 human volunteers to participate in the study. This project will determine whether SFN can prevent the drug Rifampin from binding to PXR and increasing CYP3A4 activity in humans following oral administration of SFN (broccoli sprout extract). The rate of removal of a small dose of the drug midazolam will be used to determine the enzymatic activity of CYP3A4 before and following treatment with Rifampin, in the presence or absence of SFN, since midazolam is only eliminated from the bloodstream by CYP3A4. . We predict that SFN will prevent the increase in midazolam clearance (metabolism) that normally follows treatment with the antibiotic, rifampicin. This research is important because it could potentially lead to a simple, cost-effective way of preventing one of the most common causes of adverse drug-drug interactions that occurs today. For example, rifampicin, which is a cheap and effective antibiotic used to treat TB, cannot be used in HIV/AIDS patients because it increases the metabolism of many of the antiretroviral drugs used to treat HIV/AIDS. TB is a major opportunistic infection in AIDS patients, so this is a serious clinical problem, especially in developing countries where more expensive alternative drug therapies are not available. We hypothesize that co-formulation of rifampicin with SFN could block this drug-drug interaction without altering its efficacy, thereby allowing its use in HIV/AIDS patients infected with TB. This is but one example of numerous drug-drug interactions that occur via this mechanism.
NCT00621309 ↗ Sulforaphane as an Antagonist to Human PXR-mediated Drug-drug Interactions Completed University of Washington Phase 1 2008-03-01 Adverse drug-drug interactions (DDIs) are responsible for approximately 3% of all hospitalizations in the US, perhaps costing more than $1.3 billion per year. One of the most common causes of DDIs is the when one drug alters the metabolism of another. A key enzyme in the liver and intestine, called "cytochrome P450 3A4 (CYP3A4) is generally considered to be the most important drug metabolizing enzyme. The gene for CYP3A4 can be 'turned on' by the presence of certain other drugs, resulting in much higher levels of CYP3A4 in the liver and intestine. Thus, when a drug that induces CYP3A4 is given with or before another drug that is metabolized by 3A4, a 'drug-drug' interaction occurs because the first drug (the inducer) greatly changes the rate at which the second drug (CYP3A4 substrate) is removed from the body. Many drugs increase CYP3A4 activity by binding to a receptor called the Pregnane-X-Receptor (PXR), which is a major switch that controls the expression of the CYP3A4 gene. Using human liver cells we have demonstrated that sulforaphane (SFN), found in broccoli, can block drugs from activating the PXR receptor, thereby inhibiting the switch that causes CYP3A4 induction. The purpose of this project is to determine if SFN can be used to block adverse DDIs that occur when drugs bind to and activate the PXR receptor and subsequently induce CYP3A4 activity. We will recruit 24 human volunteers to participate in the study. This project will determine whether SFN can prevent the drug Rifampin from binding to PXR and increasing CYP3A4 activity in humans following oral administration of SFN (broccoli sprout extract). The rate of removal of a small dose of the drug midazolam will be used to determine the enzymatic activity of CYP3A4 before and following treatment with Rifampin, in the presence or absence of SFN, since midazolam is only eliminated from the bloodstream by CYP3A4. . We predict that SFN will prevent the increase in midazolam clearance (metabolism) that normally follows treatment with the antibiotic, rifampicin. This research is important because it could potentially lead to a simple, cost-effective way of preventing one of the most common causes of adverse drug-drug interactions that occurs today. For example, rifampicin, which is a cheap and effective antibiotic used to treat TB, cannot be used in HIV/AIDS patients because it increases the metabolism of many of the antiretroviral drugs used to treat HIV/AIDS. TB is a major opportunistic infection in AIDS patients, so this is a serious clinical problem, especially in developing countries where more expensive alternative drug therapies are not available. We hypothesize that co-formulation of rifampicin with SFN could block this drug-drug interaction without altering its efficacy, thereby allowing its use in HIV/AIDS patients infected with TB. This is but one example of numerous drug-drug interactions that occur via this mechanism.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for RIFADIN

Condition Name

Condition Name for RIFADIN
Intervention Trials
Pulmonary Tuberculosis 3
Healthy 3
Cystic Fibrosis 2
HIV 2
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Condition MeSH

Condition MeSH for RIFADIN
Intervention Trials
Tuberculosis 7
Tuberculosis, Pulmonary 5
Cystic Fibrosis 2
Neoplasms 2
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Clinical Trial Locations for RIFADIN

Trials by Country

Trials by Country for RIFADIN
Location Trials
United States 65
South Africa 7
Canada 5
India 4
France 3
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Trials by US State

Trials by US State for RIFADIN
Location Trials
California 6
Florida 4
Texas 4
Colorado 4
Washington 4
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Clinical Trial Progress for RIFADIN

Clinical Trial Phase

Clinical Trial Phase for RIFADIN
Clinical Trial Phase Trials
Phase 4 2
Phase 3 5
Phase 2/Phase 3 1
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Clinical Trial Status

Clinical Trial Status for RIFADIN
Clinical Trial Phase Trials
Completed 27
Recruiting 4
Unknown status 2
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Clinical Trial Sponsors for RIFADIN

Sponsor Name

Sponsor Name for RIFADIN
Sponsor Trials
University of Washington 3
University of California, San Francisco 3
European and Developing Countries Clinical Trials Partnership (EDCTP) 3
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Sponsor Type

Sponsor Type for RIFADIN
Sponsor Trials
Other 80
Industry 17
NIH 5
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Rifadin (Rifampin): Clinical Trials Update, Market Analysis, and Future Projections

Last updated: October 28, 2025


Introduction

Rifadin (generic name: Rifampin) remains a cornerstone in the treatment of tuberculosis (TB) and other bacterial infections. As antibiotic resistance challenges emerge and global health priorities shift, understanding Rifadin’s current market landscape, ongoing clinical advancements, and future outlooks is critical for stakeholders ranging from pharmaceutical companies to healthcare providers. This article synthesizes recent clinical trial updates, market dynamics, and projections to provide a comprehensive analysis of Rifadin’s positioning in the pharmaceutical sector.


Clinical Trials Update on Rifadin

Recent and Ongoing Clinical Trials

Over the past two years, clinical research efforts have focused on extending Rifadin’s efficacy, reducing treatment durations, and exploring new therapeutic combinations. Notably, the following developments are significant:

  • Assessment in Multidrug-Resistant TB (MDR-TB): Multiple Phase II and III trials investigate Rifadin's role in MDR-TB treatment regimens. The STREAM (Standardized Treatment Regimen of Anti-TB Drugs for Patients with Multidrug-Resistant Tuberculosis) trial continues to evaluate whether shorter, more effective regimens can be developed by incorporating Rifadin alongside novel agents [1].

  • Combination Therapy Studies: Several trials assess Rifadin combined with newer drugs such as bedaquiline and pretomanid, aiming to optimize cure rates and minimize resistance development [2].

  • Non-TB Infectious Diseases: Emerging studies examine Rifadin’s efficacy against nontuberculous mycobacterial infections and its potential role in combating bacterial biofilms associated with implant-related infections [3].

  • Pharmacokinetic and Pharmacodynamic (PK/PD) Optimizations: Ongoing Phase I trials analyze dosing strategies to counteract resistance and adverse effects—particularly hepatotoxicity—and improve patient adherence, especially among populations with comorbidities such as HIV [4].

Regulatory Interactions and Approvals

While the initial approvals for Rifadin as an anti-tubercular agent remain unchanged, regulatory bodies in regions like the U.S. (FDA) and Europe (EMA) have shown increasing interest in approving fixed-dose combination (FDC) formulations to improve compliance and reduce resistance.


Market Analysis

Current Market Landscape

As of 2023, Rifadin maintains a dominant position in the anti-TB drug market. The global TB treatment market was valued at approximately USD 1.4 billion in 2022 and is projected to reach USD 2.1 billion by 2030, with Rifadin sales representing a significant portion [5].

Key market drivers include:

  • Endemic TB Regions: High-burden countries in Africa, Southeast Asia, and parts of Eastern Europe rely heavily on Rifadin-based regimens, especially in public health programs supported by WHO and national governments.

  • Antimicrobial Resistance (AMR): Rising MDR-TB cases have sustained demand for Rifadin, often in combination therapies, despite competition from newer agents.

  • Healthcare Infrastructure and Funding: Global health initiatives, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, continue to subsidize procurement, extending Rifadin’s reach.

Competitive Landscape

While Rifadin is an established first-line therapy, the emergence of newer anti-tuberculosis agents, including bedaquiline (Sirturo) and delamanid (Deltyba), presents competitive pressures:

  • Bacterial Resistance: Resistance to Rifampin, driven by genetic mutations in Mycobacterium tuberculosis, poses a long-term risk, prompting the development of alternative therapies and adjuvants.

  • Generic Availability: Domestic and international generic producers significantly influence pricing dynamics, especially in low- and middle-income countries (LMICs).

  • Innovator vs. Generic Dynamics: Patent protections for rifampin formulations expired decades ago, facilitating generic competition but also impacting profit margins for original manufacturers like Sanofi (historically associated with Rifadin) [6].

Market Challenges and Opportunities

  • Adherence and Resistance: Improved dosing strategies and combination therapies present opportunities to strengthen market share by reducing resistance rates and treatment failures.

  • New Formulations: Development of once-weekly or even injectable formulations could revolutionize treatment adherence, especially in resource-limited settings.

  • Emerging Indications: Expanding indications beyond TB, such as prophylactic uses or treatment of nontuberculous mycobacterial infections, open new markets.


Market Projections

Short-term Outlook (Next 3–5 Years)

  • Stable Demand in TB-Endemic Regions: Continued reliance on Rifadin in LMICs suggests steady demand, especially with the support of global health initiatives.

  • Incremental Innovation: Introduction of optimized formulations, such as fixed-dose combinations (FDCs), can improve adherence and may lead to increased market penetration.

  • Resistance Management: As concerns over Rifampin resistance grow, clinicians might adopt combination therapies incorporating newer agents, potentially impacting Rifadin’s market share unless these formulations are directly linked.

Long-term Outlook (5–15 Years)

  • Market Contraction in High-Income Countries: Due to declining TB incidence and availability of newer, more effective, and shorter regimens, Rifadin’s market share in developed countries may diminish.

  • Global Health Policies Favoring Rifadin: Despite the emergence of alternatives, WHO’s guidelines continue to recommend Rifampin as a core drug in TB therapy, sustaining its relevance.

  • Innovation-Driven Growth: The development of novel delivery systems (e.g., prolonged-release formulations) and expanded indication spectrum could sustain or even enhance long-term demand.

  • Impact of Resistance and Drug Development: The threat of extensively drug-resistant TB (XDR-TB) may necessitate combination therapies where Rifadin remains part of multi-drug regimens, justifying continued production.


Key Takeaways

  • Rifadin remains a cornerstone in TB treatment, with clinical trials focusing on resistance management, combination regimens, and expanded indications.

  • The market is characterized by regional dependencies, generics, and emerging competition from novel anti-TB agents like bedaquiline and pretomanid.

  • Despite a mature market, innovation in formulations and expanded clinical applications offer growth opportunities.

  • Global health initiatives and endemic disease burdens sustain steady demand in LMICs, even as markets in high-income countries decline.

  • The long-term outlook hinges on ongoing resistance challenges, pharmacological innovations, and policy support.


FAQs

1. What are the key clinical trial developments involving Rifadin in recent years?
Recent trials have evaluated Rifadin’s role in MDR-TB regimens, combination therapies with newer agents, and optimized dosing strategies to mitigate resistance and adverse effects. Notably, the STREAM trial continues to inform shorter, more effective treatment protocols.

2. How is Rifadin positioned against emerging anti-TB agents?
While Rifadin remains a first-line therapy supported by extensive clinical use, newer drugs like bedaquiline offer advantages in MDR-TB cases, especially for resistant strains. Rifadin’s role is therefore shifting towards combination regimens, especially in resource-limited settings.

3. What are the main market challenges facing Rifadin?
Challenges include antimicrobial resistance compromising efficacy, competition from newer drugs, patent expirations leading to generics, and shifting treatment guidelines favoring shorter regimens with alternative agents.

4. What opportunities exist for Rifadin’s market growth?
Opportunities include developing combination formulations, expanding indications in non-tuberculous mycobacterial infections, and leveraging global health programs to maintain steady demand in high-burden regions.

5. How might future developments impact Rifadin’s market longevity?
Innovations in drug delivery, evolving resistance patterns, and global health policies could extend Rifadin’s relevance. However, the anticipated decline in TB incidence in some regions and competition from newer agents could diminish its market share over time.


References

[1] World Health Organization. Treatment of MDR-TB: Latest updates. 2022.
[2] Kadura, S., et al. “Combination Therapy in MDR-TB: An Update.” Journal of Infectious Diseases, 2022.
[3] Lee, C. et al. “Rifampin’s Emerging Role in Non-Tuberculous Mycobacterial Infections.” Infection and Immunity, 2023.
[4] Johnson, R., et al. “PK/PD Optimization of Rifampin in Special Populations.” Clinical Pharmacology, 2023.
[5] MarketWatch. “Global Tuberculosis Drugs Market Size & Forecast.” 2023.
[6] European Medicines Agency (EMA). Generic Rifampin Approvals. 2022.

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