Three new treatment methods: scientists have developed several strategies to combat tuberculosis.
Tuberculosis (TB) remains one of the leading infectious diseases causing death worldwide, a situation worsened by the increasing prevalence of drug-resistant strains. However, researchers have recently made significant strides in TB treatment due to an international clinical study that identified three new safe and effective treatment regimens for rifampicin-resistant disease, as reported by Harvard Medical School.
The study, published in the New England Journal of Medicine, was conducted by scientists from Harvard Medical School and the EndTB project, which involves organizations such as Partners In Health, Médecins Sans Frontières, and Interactive Research and Development. The new treatment methods utilize newly developed drugs, enabling shorter treatment courses, minimizing side effects, and improving accessibility for patients who previously relied on daily injections.
During the trial, researchers tested five new nine-month treatment combinations using bedaquiline and delamanid—two anti-TB drugs introduced in 2012-2013 after nearly 50 years without new treatment options. Unlike older regimens that often lasted for years and included toxic drugs with severe side effects, these new combinations offer alternatives in cases of drug intolerance, shortages, or additional resistance.
The third drug, pretomanid, received emergency FDA approval in 2019 but was not included in this study due to its later market entry. The aim of the study was to determine whether these treatment regimens could at least match existing treatment standards based on strict World Health Organization (WHO) guidelines. The trial involved 754 patients from seven countries—Georgia, India, Kazakhstan, Lesotho, Pakistan, Peru, and South Africa—where rifampicin-resistant tuberculosis is a significant issue.
According to WHO estimates, 410,000 people develop rifampicin-resistant tuberculosis each year, yet only 40% receive diagnosis and treatment, with a treatment success rate of just 65% among these patients. The new study demonstrated an 85-90% success rate for the three most effective treatment regimens, surpassing the 81% success rate of the control group that received longer treatment as recommended by WHO.
The research also included historically overlooked population groups, such as children, individuals infected with HIV or hepatitis C, and pregnant women—groups often excluded from clinical trials.
Based on these results, WHO incorporated the three new regimens into its official recommendations for treating rifampicin-resistant tuberculosis and multidrug-resistant tuberculosis in August 2024. A crucial breakthrough in accessibility was achieved through efforts to reduce treatment costs. Recent actions to end patent exclusivity on bedaquiline have allowed the sale of two EndTB regimens and the WHO-recommended regimen containing pretomanid for under $500—a price point that activists have sought for over a decade.
The combination of more affordable pricing and shorter treatment courses for all medications means that a greater number of tuberculosis patients worldwide will have access to effective treatment than ever before. Carol Mitnick, one of the lead researchers of the endTB trial and a professor of global health and social medicine at Harvard Medical School, emphasized the significance of this collaboration in the fight against this dangerous and widespread disease.
Important! This article is based on the latest scientific and medical research and does not contradict it. The text is for informational purposes only and does not contain medical advice. For diagnosis, please consult a physician.