Infectiology. In the fight against tuberculosis, a new therapeutic weapon confirms its interest. This weapon is a shorter protocol, based on four antibiotics administered orally. It is aimed at so-called “multidrug-resistant” forms of tuberculosis, which do not respond to first-line therapies (isoniazid and rifampicin).
This protocol has been tested in three countries, Belarus, South Africa and Uzbekistan, on 301 people with multidrug-resistant tuberculosis. Its interim results were presented on October 22 by Médecins Sans Frontières (MSF), which conducted the trial, at the World Conference on Lung Health.
This treatment combines, over a period of six months, bedaquiline, pretomanide, linezolid and moxifloxacin. During the interim analysis, it was shown “Very effective against resistant tuberculosis”, MSF announces: 89% of the patients in the group who benefited from it were cured, compared to 52% of those who received the standard treatments recommended by the World Health Organization (WHO) for multidrug-resistant forms (control group). Those who no longer had Koch’s bacillus (the bacteria responsible for the disease) in their sputum and who no longer showed clinical signs of the disease were declared cured. Four patients in the control group, on the other hand, died of tuberculosis or side effects of the treatment, compared with none of those benefiting from the new protocol. In the latter group, 80% of patients experienced no noticeable side effects, compared to 40% of those in the control group.
“These results seem promising, but we will have to wait until we have more precise data on the treatments of the control group”, estimates Professor Nicolas Véziris, head of the National Reference Center on Mycobacteria at Saint-Antoine Hospital (AP-HP), who did not participate in the trial. He notes that the control group performed poorly, which makes it a very favorable comparator for the new protocol.
“Move the lines”
Nevertheless: this test, named TB-Practecal, is “The first in the world to evaluate in a randomized and controlled manner the interest of a short treatment against multidrug-resistant tuberculosis”, greets the infectious disease specialist. Clearly, the patients were randomly divided into two groups which were compared, the first receiving the new treatment, the second the standard treatments recommended by the WHO.
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