Study Finds Three New Safe, Effective Ways To Treat Drug-Resistant Tuberculosis

New options make care faster, safer, and more accessible

The germs that cause tuberculosis appear as clumps of red and yellow rod-shaped particles on a jade-green background.
Scanning electron micrograph of Mycobacterium tuberculosis particles (colorized red/yellow), the bacterium which causes TB. Image: NIAID

At a glance:

  • Study finds three new safe and effective drug regimens to fight multidrug-resistant TB

  • The treatments, which include recently discovered TB drugs, give new options for shorter, personalized treatment and are cleared for use for more people than ever

Tuberculosis remains one of the top infectious disease killers worldwide, a challenge amplified by drug-resistant forms of the disease. Now, in a major step forward, an international clinical trial has found three new safe and effective drug regimens for tuberculosis that is resistant to rifampin, the most effective of the first-line antibiotics used to treat TB.

The research, published Jan. 30 in the New England Journal of Medicine, was led by researchers at Harvard Medical School and other members of the endTB project, a collaboration among Partners In Health, Médecins Sans Frontières, and Interactive Research and Development, with help from researchers and clinicians at academic medical centers and research hubs worldwide. The trial was funded by Unitaid, the U.S. National Institutes of Health, the Research Foundation Flanders, and the Wellcome Trust.

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The newly identified regimens take advantage of recently discovered drugs to expand the treatment arsenal and give physicians new ways to shorten and personalize treatment, minimize side effects, and treat patients using only pills instead of daily injections. They also offer alternatives in case of drug intolerance, medication shortages or unavailability, or drug resistance, the researchers said.

The endTB trial is one of four recent efforts to use randomized controlled trials to test new, shorter, less toxic regimens for drug-resistant TB. endTB uses two new drugs — bedaquiline and delamanid — which, when brought to market in 2012-2013, were the first new TB medicines developed in nearly 50 years.

This HMS-led collaboration among NGOs, ministries of health, and other academic partners will make lifesaving care dramatically more accessible.

Carole Mitnick

Authorship, funding, disclosures

Additional authors include Lorenzo Guglielmetti, Uzma Khan, Gustavo E. Velásquez, Maelenn Gouillou, Amanzhan Abubakirov, Elisabeth Baudin, Elmira Berikova, Catherine Berry, Maryline Bonnet, Matteo Cellamare, Vijay Chavan, Vivian Cox, Zhanna Dakenova, Bouke Catherine de Jong, Gabriella Ferlazzo, Aydarkhan Karabayev, Nana Kiria, Mikanda Kunda, Nathalie Lachenal, Leonid Lecca, Helen McIlleron, Ilaria Motta, Sergio Mucching Toscano, Hebah Mushtaque, Payam Nahid, Lawrence Oyewusi, Samiran Panda, Sandip Patil, Patrick P.J. Phillips, Jimena Ruiz, Naseem Salahuddin, Epifanio Sanchez Garavito, Kwonjune J. Seung, Eduardo Ticona, Lorenzo Trippa, Dante E. Vargas Vasquez, Sean Wasserman, Michael L. Rich, and Francis Varaine.

The trial was funded by a grant (SPHQ15-LOA-045) from Unitaid; by a grant (FWO G0A7720N) from the Research Foundation Flanders; by a grant (K08 AI141740) from the National Institute of Allergy and Infectious Diseases of the U.S. National Institute of Health; by a grant (206379/Z/17/Z) from Wellcome Trust; and by Médecins Sans Frontières, Partners In Health, and Interactive Research and Development, which provided in-kind support for trial implementation and administration.