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
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