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Wednesday, 19 February, 2025
HomeEditor's PickClinical trial reveals 'breakthrough' treatment options for MDR-TB

Clinical trial reveals 'breakthrough' treatment options for MDR-TB

Clinical trial results presented at the Union World Conference on Lung Health in Paris last week provided evidence to support the use of four new, improved regimens to treat multi-drug resistant tuberculosis – or rifampicin-resistant tuberculosis (MDR/RR-TB).

The endTB clinical trial found three new drug regimens that can deliver similar efficacy and safety to conventional treatments while reducing treatment time by up to two-thirds. It also found a fourth regimen that can be used as an alternative for people who cannot tolerate bedaquiline or linezolid, staples in current WHO-recommended regimens for MDR-TB.

The endTB consortium, made up of Médecins Sans Frontières (MSF), Partners In Health (PIH) and Interactive Research and Development (IRD), began this phase three randomised controlled trial in 2017.

A group of 754 patients from Georgia, India, Kazakhstan, Lesotho, Pakistan, Peru and South Africa were enrolled and included teenagers and people with comorbidities like substance-use disorders.

Health Policy Watch reports that it evaluated five nine-month treatment regimens against the standard of care, with three of the drugs showing favourable outcomes in 85%-90% of participants.

“We stand on the cusp of a significant breakthrough in the battle against MDR, a disease that disproportionately affects impoverished populations around the globe,” said Professor Carole Mitnick, the study’s co-principal investigator.

“But the cost of some drugs remains a barrier. One example is delamanid still priced at 12-40 times higher than it should be, according to an independently estimated cost to produce the drug,” said Mitnick, professor of Global Health and Social Medicine at Harvard Medical School.

MDR/RR-TB is caused by a TB bacterium that is resistant to rifampicin, one of the most powerful first-line antibiotics, and also sometimes resistance to isoniazid as well. Roughly half a million people fall sick with MDR/RR-TB each year, and many die from it.

While various MDR-TB regimens are now in use worldwide, many people are still treated with conventional treatments that take up to 24 months, are ineffective (only 59% treatment success in 2018), and often cause terrible side effects, including acute psychosis and permanent deafness.

Leaflet endTB results Nov 2023

Health Policy Watch article – https://healthpolicy-watch.news/trial-finds-four-new-treatment-options-for-multidrug-resistant-tuberculosis/ (Open access)

 

See more from MedicalBrief archives:

 

MSF trial finds better, shorter, more effective treatment for MDR-TB

 

Promising results from stage 2 MDR-TB STREAM – world’s largest trial

 

Long wait for South Africa to benefit from J&J MDR-TB drug patent lifting

 

 

 

 

 

 

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