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.
Abstract
A review of the STREAM trial, which evaluates the safety and efficacy of new treatment regimens for MDR-TB http://ow.ly/VtVkQ
Footnotes
This study is registered at ClinicalTrials.gov with identifier number NCT02409290.
Support statement: The primary funder of the trial is the United States Agency for International Development (USAID) through the Cooperative Agreement GHN-A-00-08-00004-00. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government. Additional funding was provided by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement. No funders were involved in the design of the study, collection and analysis of the data or its interpretation, nor did they contribute to the writing of the manuscript or to the decision to submit the manuscript for publication. All authors are receiving financial support from the funders of the trial. Additional funding for STREAM stage 2 will be provided by Janssen Pharmaceuticals. Funding information for this article has been deposited with FundRef.
Conflict of interest: None declared.
Provenance: Submitted article, peer reviewed.
- Received November 2, 2015.
- Accepted November 22, 2015.
- Copyright ©ERS 2016.
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