Study shows effective TB regimen reduces treatment time by one-third

Conference News 21 Oct 2020

Leading lung health researchers announced important new developments in tuberculosis (TB) research at the Union World Conference today.

This includes promising new data from a clinical trial demonstrating that treatment time for people living with TB can be reduced by a third. Typically, TB treatment currently lasts at least six months, but the study reported that participants were TB-free after a regimen of four months.

Susan Dorman of the Medical University of South Carolina presented the results from this randomised, controlled trial, which enrolled more than 2,500 participants from 13 countries.

“This is the first clinical trial to identify a shorter regimen that works as well as the standard six-month regimen” said Dorman. “A shorter regimen will enable people with TB to be cured faster and may reduce treatment costs, improve quality of life and help more people successfully complete their treatment.”

Research shows cost of not ending TB by 2030 will be US$3 trillion and over 28 million deaths

This study gives the first estimate of the full-income losses due to TB mortality until 2050. It estimated cause-eliminated life expectancy in 165 countries, if TB deaths fell by 2 percent annually.

Sachin Silva of Harvard University presented the study and reported that failure to achieve the End TB targets by 2030 will have devastating economic impacts on countries with high prevalence of HIV and TB, especially in sub Saharan Africa.

The economic and human cost of not ending TB by the UN target of 2030 and instead the more likely date of 2045, will be to the order of some US$3 trillion, with 5.7 million avoidable TB deaths.

Silva noted that COVID-19 has certainly made 2045 the more likely scenario, suggesting even a brief shut down in TB programmes because of the pandemic is likely to have calamitous epidemiologic and economic consequences.

Targeted universal testing in high risk groups successful in finding missing patients

“There is a growing awareness that symptom-based screening doesn’t catch everyone, and our study was designed to find these missing cases”, said Rebecca Berhanu of Boston University, reporting on a study evaluating the effectiveness of TB screening based on risk-factor, rather than symptoms.

The ‘Targeted Universal Testing for Tuberculosis’ cluster-randomised trial, included more than 22,000 participants in 60 primary health care facilities in South Africa. Six percent of people in the study were found to have TB, even without symptoms.

“These results add to the mounting evidence that passive case detection, based on symptom-based screening alone, is not sufficient to identify all cases of TB.” said Berhanu.

While TB control programmes use symptom-based screening to identify individuals for further investigation, these results confirm that this approach does not find all patients with TB.

Other announcements included promising new insights on the birth outcomes of pregnant women exposed to isoniazid preventive therapy, the potential feasibility of using an adapted PPE mask attached with a gelatin membrane to collect sputum from children and a study by U.S. researchers demonstrating the economic and human cost of not meeting the UN target of ending TB by 2030.
See the full results:

Session: Health Economics, Friday 23rd October, 15:00 – 16:20 Abstract: Assessing the economic impact of TB mortality in 165 countries: what it will cost if we don’t achieve the End TB targets (OA-29-680-23)

Session: Identification and management of TB infection, Friday 23rd October, 11:00 – 12:20 CEST. Abstract: Finding missing patients: yield of targeted universal testing for tuberculosis in high-risk groups presenting to 30 primary health care facilities in South Africa (OA-23-646-23). Friday 23rd October, 11:00 – 12:20 CEST

Session: High-dose rifapentine with or without moxifloxacin for shortening treatment of TB – TB Trials Consortium study 31/ACTG A5349 phase III clinical trial results, Wednesday 21 October, 16:30 – 17:50 CEST. Abstract: The design and primary efficacy results of Study 31/A5349

Session: TB diagnostics, including drug-resistance determination Thursday 22nd October, 11:00 – 12:20. Abstract: Non-invasive respiratory aerosol sampling using masks for detection of pulmonary tuberculosis in children.    

Session: TB and co-morbidities: including HIV and diabetes, Wednesday 21 October, 11:00-12:20 CEST. Abstract: Birth outcomes of pregnant women exposed to isoniazid preventive therapy.

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