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Hope to ease TB drug burden

Thursday October 23rd, 2014

Gruelling courses of treatment to tackle TB could become more acceptable and effective, according to two studies published yesterday.

British researchers said it was possible to cut the number of drugs taken by patients undergoing standard treatment for TB.

A study conducted in southern Africa found the number of tablets taken over a six-month course of treatment could be cut by a third.

Standard treatment would require patients to take 420 tables during this period.

The study, led by St George's, University of London, allowed patients to take treatment weekly rather than daily during the last four months of treatment - when four drugs are reduced to two drugs.

The study, reported in the New England Journal of Medicine found that 97% of patients were still cured - while 95% were cured using standard treatment.

The weekly treatment tested in the trial involved the drugs rifapentine and moxifloxacin rather than the standard combination of rifampicin and isoniazid.

Researcher Dr Amina Jindani said: "Less tablets means there is a higher chance of the patient completing their treatment. It also makes it easier for clinics to supervise treatment.

"This is particularly important for countries where clinics are severely under resourced and where it is not uncommon for patients to travel many miles to receive each treatment."

* A second study by Belgian researchers suggests that intensive treatments for multi-drug resistant TB could be shorted.

Currently patients have to stay under treatment for 18 months to two years.

But a study in Bangladesh has found a course of treatment that need only be continued for nine months, researchers say.

The findings have been reported in the International Journal of Tuberculosis and Lung Disease.

A study involving 500 patients found an 85% success rate. The researchers say part of the key to success is "intensive" socio-economic support for patients.

Researcher Professor Bouke de Jong, of the Institute of Tropical Medicine, Antwerp, said: "The Bangladesh regimen shows that multi-resistant tuberculosis can now be cured, especially when good socio-economic support is given to patients.

"We can avoid resistance if we optimally combine available medicines and if these principles are respected in TB control programmes worldwide."

* The world has half a million more people with TB than previously thought, according to a major new analysis.

The World Health Organisation report shows that nine million people contracted the disease last year and 1.5 million people died from it.

WHO says the increased number is because of improved data rather than increasing incidence of the disease.

It says the number of people contracting the disease is now falling slightly every year - by about 1.5% - and the death rate has fallen by 45% in the last 25 years.

WHO says that still a "staggering" number of lives are lost to the disease and that the tuberculosis bacterium is the second most deadly single infectious agent on the planet.

In addition the world has failed to make headway in tackling multi-drug resistant strains, it warns, and these were responsible for some 480,000 infections last year.

WHO TB director Dr Mario Raviglione said: "Following a concerted effort by countries, by WHO and by multiple partners, investment in national surveys and routine surveillance efforts has substantially increased.

"This is providing us with much more and better data, bringing us closer and closer to understanding the true burden of tuberculosis."

N Engl J Med 22 October 2014;371:1599-608; doi:10.1056/NEJMoa1314210

International Journal of Tuberculosis and Lung Disease October 2014

Tags: Africa | Asia | Europe | Pharmaceuticals | Respiratory | UK News | World Health

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