Beruflich Dokumente
Kultur Dokumente
Union-Supported Research
Outline
MDR-TB burden and shortcomings of current treatment
Union involvement in shortened MDR-TB regimens
Bangladesh MDR-TB treatment pilot project
West Africa observational study
STREAM clinical trial
Other treatment-shortening research
Conclusions
MDR-TB burden
and treatment limitations
Outline
WHO estimates* approximately 480,000 new MDR-TB cases
globally in 2014
Only a quarter of these estimated cases are detected and
treated
Of reported MDR-TB patients treated only 50% are treated
successfully
Currently recommended treatments are lengthy and often
difficult to tolerate
* World Health Organizations Global Tuberculosis Report 2015
Bangladesh Regimen
Daily treatment for 9 months
Months**
Drug
Kanamycin*
Isoniazid (H)
Prothionamide
Clofazimine
Gatifloxacin
Ethambutol
Pyrazinamide
1-4
1-4
1-4
1-9
1-9
1-9
1-9
82.5%
Completion
5.3%
2.3%
Default
5.8%
7.8%
Death
Failure
Relapse
5.3%
5.6%
0.5%
1.4%
0.5%
0.8%
Overall success rate:
84.5%
Int J Tuberc Lung Dis 2014
Randomised trial
STREAM Trial
Randomised trial
STREAM Trial
West African
Outline
Cohort Study
Observational cohort study of 1000 patients on a modified
Bangladesh regimen
Nine countries of francophone Africa are participating :
Benin, Burkina Faso, Burundi, Cameroon, Central African
Republic, Cte d'Ivoire, DR Congo, Niger, Rwanda
Interim analysis of 408 patients demonstrated 82.1%
treatment success*
*Kuaban et al. Late breaker session. 46 th Union World Conference on Lung Health, Cape Town.
Randomised trial
STREAM Trial
STREAM
Outline
Trial Design
Ethiopia (Addis
Ababa)
Vietnam
(Ho Chi Minh)
South Africa (Sizwe, Durban,
Pietermaritzburg)
Actual
Planned
424
400
Completion of recruitment:
July 2015
Q4 2017
Results expected:
Q1 2018
STREAM Stage 2
After extensive discussions between the study team, the
local investigators and other experts it was agreed that
additional regimens to be evaluated of primary interest to
patients and programmes would be:
a fully oral 9-month regimen
a 6-month simplified regimen
Both of these regimens include bedaquiline as part of a
broader agreement for support with Janssen
Pharmaceuticals
Actual
First patient enrolled:
Enrolled
Planned
March 2016
10
1155
Completion of recruitment:
Q3 2018
Q1 2021
Q3 2020
Conclusions
Acknowledgements
irusen@theunion.org