More effective treatment for drug-resistant TB found

An effective and short treatment to treat multi-drug resistant (MDR) tuberculosis is in the offing, with preliminary findings from clinical studies showing promise for a shorter nine-month treatment course for MDR-TB.

The findings presented at the 46th Union World conference on lung health in Cape Town revealed that the new regimen is likely to save the lives of many who are otherwise not easy to treat and suffer serious side-effects due to lengthy treatment.

With a success rate of more than 80 per cent, the new regimen experts say-doesn’t lead to “unmanageable” side-effects. At present, the standard treatment length recommended by the World Health Organisation requires 24 months of treatment with frequent injections.

However, updates to WHO’s MDR-TB treatment guidelines are anticipated in 2016, and experts hope that data provided by the studies will have an important impact on these new treatment guidelines.

In their study involving 507 adult patients from nine countries, experts found that 80.9 per cent had treatment success, 7.7 per cent died, 6.5 per cent were lost to follow-up and 4.9 per cent were treatment failures.

Arnaud Trebucq of the Union, who led the study said that “implementing the shortened regimen is proving feasible, and with improved outcomes compared with the standard MDR-TB treatment”.

The experts are also waiting for findings for another STREAM trial, sponsored by the Union and implemented with the support of the British Medical Research Council and from USAID, which is also testing the efficacy of a nine-month treatment regimen.

The first phase of the trial is ongoing in Durban, Sizwe and Pietermaritzburg, Vietnam and Mongolia.

STREAM is the first randomised clinical trial of this scope being conducted in Mongolia for any disease. Patient enrollment was completed with 420 patients included in the study and results are anticipated in 2017.

The STREAM trial is also expanding to test another nine-month MDR-TB treatment regimen using bedaquiline, a novel medicine. These trials will test two additional MDR-TB treatment regimens-a nine-month, all-oral regimen that does not require injections, and an even shorter six-month regimen.

“Among all the infectious diseases, MDR-TB has required one of the longest and most complex courses of treatment,” said I.D. Rusen, senior vice-president of research and development at the Union, which coordinated the study.