Short-course treatment for multidrug-resistant tuberculosis: the STREAM trials
Riya Moodley, Thomas R Godec, STREAM Trial Team, Francesca Conradie, Iqbal Master, Ronelle Narasimooloo, Tesfamariam Mebrahtu, Daniel Meressa Kokebu, Nguyen Thi Ngoc Lan, Phan Thuong Dat, Bazarragchaa Tsogt, Naranbat Nyamdavaa, Riya Moodley, Thomas R Godec, STREAM Trial Team, Francesca Conradie, Iqbal Master, Ronelle Narasimooloo, Tesfamariam Mebrahtu, Daniel Meressa Kokebu, Nguyen Thi Ngoc Lan, Phan Thuong Dat, Bazarragchaa Tsogt, Naranbat Nyamdavaa
Abstract
Multidrug-resistant (MDR) tuberculosis (TB) is a threat to global TB control, as suboptimal and poorly tolerated treatment options have resulted in largely unfavourable outcomes for these patients. The last of six cohort studies conducted in Bangladesh which assessed a new shorter regimen using currently available TB drugs showed promising results and offered the possibility of a more acceptable and more effective regimen than the one recommended by the World Health Organization (WHO). The aims of stage 1 of the STREAM (Evaluation of a Standardised Treatment Regimen of Anti-tuberculosis Drugs for Patients with Multidrug-resistant Tuberculosis) trial are to evaluate the efficacy and safety of this regimen, compared to the current WHO-recommended standard of care. Stage 2 evaluates two new bedaquiline-containing regimens: one an all-oral regimen and the second a further shortened and simplified version of the stage 1 study regimen, comparing the efficacy and safety of each to that of the stage 1 study regimen and also to the WHO-recommended standard of care. Success of the stage 1 study regimen would in all probability provide a new standard of care for MDR-TB patients, while positive results from the bedaquiline-containing regimens in stage 2 may allow for even greater progress in the management of this difficult population.
Trial registration: ClinicalTrials.gov NCT02409290.
Conflict of interest statement
Conflict of interest: None declared.
Copyright ©ERS 2016.
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Source: PubMed