Drug-resistant tuberculosis research offers hope for patients
Results presented today give new hope to patients with extensively drug-resistant tuberculosis (XDR-TB). At a press conference on research results on drug-resistant TB (DR-TB), Francesca Conradie, South Africa, shared the interim results of a clinical study using three drugs for the treatment of XDR-TB. This three-drug regimen was trialed on patients in South Africa, half of whom were also HIV positive.
"XDR-TB is TB that is resistant to the four main TB drugs that we have and the mortality rate is very high, with four out of five patients dying," said Dr Conradie, “Prior XDR-TB treatment consisted of the kitchen sink approach; we just gave every drug that we had."
Dr Conradie presented initial results showing that out of 50 patients, 30 patients have been completely cured, 17 patients are being successfully treated, and there have been just three deaths (and those patients had advanced TB before entering the study).
Dr Conradie described these results as a “phenomenal breakthrough in treating XDR-TB” and that this felt to her like the early days of treating HIV, where there is suddenly hope for dying patients. “This is the most rewarding protocol I’ve worked on, because patients go home and get better. We're actually in a little bit of trouble because our wards are empty, but I think that's a good thing."
“DR-TB is one of the most challenging diseases any person could ever face. But we’re starting to see promise in shorter, more effective treatments that have the hope of eliminating some of the most difficult parts of the treatment experience,” said Dr Paula I Fujiwara, Scientific Director of the International Union Against Tuberculosis and Lung Disease (The Union).
Additionally, at the press conference the researchers demonstrated promising results from experimental treatments and models of providing health care to patients suffering from multidrug-resistant TB (MDR-TB). They also announced new data showing that TB drug resistance can develop quickly, and that a significant percentage of patients who are diagnosed with DR-TB could have been diagnosed earlier. Late diagnosis is more likely to lead to treatment complications and worse treatment outcomes.
These trials all use the shorter treatment regimen, which reduces the length of treatment from 20 or more months to only nine months, and is recommended by the WHO as the new standard approach to treat MDR-TB.
Erika Mohr from Médecins Sans Frontières (MSF) discussed the missed opportunities for rapid diagnosis of DR-TB in South Africa. The researchers found there were missed opportunities for diagnosing DR-TB earlier in 28 percent of cases. Earlier diagnosis improves patient outcomes and reduces TB transmission within the community.
Animesh Sinha, MSF Russia, shared results about the effectiveness of TB treatment regimens for DR-TB in the Chechen Republic.
Esther Casas, MSF Swaziland, delivered results from implementing the short-course regimen for MDR-TB in a high HIV prevalence setting. Dr Casas described how the study treated patients in their home, in a clinic and in an outreach setting, with an emphasis on psycho-social support.
These measures demonstrated high rates of treatment success: Of the 80 patients who completed treatment, 75% were treated fully.
One patient in the study said, “I’m so glad that I chose to be treated using the shorter treatment; the mobile team has been so supportive. Since I completed my treatment I can even play soccer again.”