Study sets ‘benchmark’ for TB treatment
Next study reveals effectiveness of novel all-oral six-month treatment regime
The findings of a new study have been hailed by medical experts as an advancement for tuberculosis control, particularly multidrug-resistant TB.
The NExT study has revealed that a novel all-oral sixmonth treatment regime is as, if not more, effective for multidrug-resistant tuberculosis (MDR-TB) when compared to the World Health Organisation (WHO) approved ninemonth injectable-based regimen.
According to the WHO, the bacteria that cause tuberculosis can develop resistance to the antimicrobial drugs used to cure the disease.
MDR-TB does not respond to the two most effective antiTB drugs — isoniazid and rifampicin.
The results of the NExT study, funded by the SA Medical Research Council, were released in June. .
According to the medical research council, a key finding was that the new regimen was more than twice as likely to lead to a favourable outcome than the traditional approach.
The primary aim of the randomised TB trial was to determine whether treatment for multidrug-resistant TB and rifampicin-resistant TB could be shortened to six months using oral medication — the same length used for drug-sensitive TB.
The study was performed in Cape Town, George, Gqeberha, Durban and Klerksdorp.
According to the council, these findings suggest a sixmonth oral regimen for MDRTB is feasible.
“With better and more selective drug combinations, even better outcomes will likely be achievable,” it said in a statement.
“Using a shorter, oral sixmonth regimen will mean painful and toxic injectable drugs will be avoided, and the shorter regimen is likely to improve compliance, completion rates and reduce overall cost to programmes.”
University of Cape Town and London School of Hygiene and Tropical Medicine principal investigator of the study, Prof Keertan Dheda, said the NExT study set a new benchmark for the treatment of MDRTB, which threatened to derail TB control in many parts of the world.
“The next step will be to test more effective sixmonth regimens that can improve treatment success closer to 90% or even higher.
“Sixty percent of the world’s MDR-TB patients have no access to treatment, and of the remainder, most in many TB-endemic countries do not have access to the newer drugs,” Dheda said. Medical research council president and chief exTB ecutive Prof Glenda Gray welcomed the findings and described them as a huge advance in TB control in SA and beyond. “Not only do the findings have the potential to change TB clinical practice but they could also transform the way we treat patients with drug-resistant forms of TB here at home and in other parts of the world,” Gray said.