International clinical trial identifies three new regimens for rifampin-resistant TB, using recently discovered drugs to provide shorter, personalized treatment with fewer side effects. WHO recommends these regimens, boosting access to life-saving care for vulnerable populations.
Tuberculosis (TB) remains a leading infectious disease killer worldwide, with drug-resistant forms posing a significant challenge. In a breakthrough development, an international clinical trial has identified three new safe and effective drug regimens for rifampin-resistant TB. These regimens, led by researchers at Harvard Medical School and the endTB project, leverage recently discovered TB drugs to offer shorter, personalized treatment options with minimal side effects.
Patients can receive treatment entirely through oral medication, eliminating the need for daily injections. This is a major advancement in TB care, as the disease often disproportionately affects vulnerable populations, including children, HIV-infected individuals, and pregnant women. These groups are often excluded from clinical trials, but the endTB trial included them, ensuring these new treatments reach those who need them most.The endTB trial, one of four recent efforts to develop shorter, less toxic drug regimens for drug-resistant TB, tested five new, all-oral 9-month regimens using bedaquiline and delamanid, two novel TB drugs introduced in the 2010s. These regimens were compared to a standard of care treatment, and the results showed that three of the new regimens were successful in treating between 85 and 90 percent of patients, exceeding the success rate of the control group (81 percent). The trial, launched in 2017, enrolled 754 patients across seven countries: Georgia, India, Kazakhstan, Lesotho, Pakistan, Peru, and South Africa. The World Health Organization (WHO) estimates that around 410,000 people develop rifampin-resistant TB each year, including multidrug-resistant TB (MDR-TB). Currently, only 40 percent are diagnosed and treated successfully, highlighting the urgent need for improved treatment options.The WHO has endorsed the three non-inferior regimens identified in the endTB trial for treating both rifampin-resistant and multidrug-resistant TB. This recommendation extends to previously neglected groups like pregnant women and individuals living with HIV or hepatitis C. Furthermore, recent efforts to end patent exclusivity on bedaquiline have made two of the endTB regimens, along with the WHO-recommended pretomanid-containing regimen, available for less than $500. This cost-effectiveness is a significant milestone, as activists have been advocating for this price target for over a decade. These innovations collectively mean that these shortened, all-oral regimens are accessible to a larger population than ever before. The endTB trial marks a turning point in how the world confronts tuberculosis. It provides hope for a future where effective, affordable TB treatment is available to all who need it, ultimately contributing to the global goal of ending the TB epidemic
Tuberculosis Drug-Resistant TB Treatment Regimens Clinical Trial WHO Recommendations Access To Medicine
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