Research delivering on war against TB

The World Health Organization announced on Thursday new recommendations for a nine-month shortened treatment regimen for multi-drug resistant tuberculosis (MDR-TB) patients thanks to results of years of research and clinical studies from The Union and its partners.

The current recommended MDR-TB standard treatment used in most regions worldwide is an arduous 24-month regimen involving a large quantity of antibiotics, many with terrible side effects, including permanent hearing loss.  The treatment is burdensome for clinicians to administer and extremely difficult for patients to endure.

“The shortened regimen reduces the previous standard treatment by 13 months.  That is phenomenal when you think how that translates to the impact on the resources of health care systems, the lives of patients who have jobs, families and other demands on their time.  It is huge when looked at within the environment of low- and middle-income countries that face so many other challenges on their often-depleted resources and infrastructure.  It is remarkable when viewed in the context of a patient’s suffering”, said José Luis Castro, Executive Director, The International Union Against TB and Lung disease.

At less than US$ 1000 per patient, the new treatment regimen can be completed in 9–12 months. Not only is it less expensive than current regimens, but it is also expected to improve outcomes and potentially decrease deaths due to better adherence to treatment and reduced loss to follow-up.

The shorter regimen is recommended for patients diagnosed with uncomplicated MDR-TB, for example those individuals whose MDR-TB is not resistant to the most important drugs used to treat MDR-TB (fluoroquinolones and injectables), known as “second-line drugs”. It is also recommended for individuals who have not yet been treated with second line drugs.

WHO’s recommendations on the shorter regimens are based on initial programmatic studies involving 1200 patients with uncomplicated MDR-TB in 10 countries . WHO is urging researchers to complete ongoing randomised controlled clinical trials in order to strengthen the evidence base for use of this regimen.

Researchers working on the frontline have surmounted financial and logistical challenges to deliver a treatment regimen that will ultimately revolutionise how we care for patients in communities worldwide.

MDR-TB is a public health emergency. Annually, 480,000 people contract MDR-TB – and the number is rising.  So this moment is the start of the process – not the end.  The onus is on us all to ensure that access to correct treatments, both for patients and health care providers, increases exponentially.  That is why our on-going studies into even shorter regimens will continue.  Research and evidence is fundamental to beating this disease.

José Luis Castro said the international TB community must continue to advocate for investment in the expansion of quality basic services and preventative care on the frontline where it matters most.  Only then can we stop this disease in its tracks.