One of the first patients to have survived Extra Drugs Resistant (XDR) TB receiving medication from a nurse at a Tubercolosis ward. Credit: MUJAHID SAFODIEN/AFP via Getty Images
Two treatment regimens for a new anti-tuberculosis drug could improve success rates in patient with multidrug resistant (MDR) tuberculosis, at lower costs for patients, researchers say.
Results from the largest ever TB treatment trial, STREAM, shows that two shortened regimens, a 9-month oral bedaquiline regimen and 6-month regimen with bedaquiline and 8 weeks of second-line injectable, have superior efficacy with fewer cases of hearing loss, compared with a 9-month injectable-containing regimen. The results were presented at the Union World Conference on Lung Health 2022 (WCOLH).
In the study, hearing loss, which is a major concern historically for multi-drug-resistant TB treatment was reduced in the oral regimen from 8% to 2% and in the six-month injectable regimen, down to 4%. The direct cost to patients was reduced with both treatment regimens.
“Increased effective treatment options, means better choices for people with TB, which ultimately improves treatment outcomes and quality of life,” said Guy Marks, president of The Union, convenor of the World Conference.
Of those treated with the oral regimen there was 83% efficacy, compared with 71% in a comparative regimen, while with the six-month injectable 91% had a positive outcome compared to 69% of the control. This indicates primary efficacy outcome was favourable status at 76 weeks with a negative culture for Mycobacterium tuberculosis.
Specifically, the researchers concluded the treatment option makes an important contribution to the growing body of evidence available to support treatment guidelines for MDR. In addition to the efficacy and safety of the regimens as well as the health economic component of STREAM stage 2 provides evidence on the probable costs of their implementation from both provider and patient perspectives. The results validate World Health Organisation’s (WHO) current recommendation of a month oral regimen as an option for treatment for MDR-TB.
