Targeted treatments may improve tuberculosis therapy

Treatment regimens for tuberculosis (TB) could be shortened by two months for some patients, according to an analysis of data from over 3,000 individuals previously treated for TB, reports a paper published online this week in Nature Medicine.

TB kills more people than any other infectious disease. Although effective TB therapy exists, it consists of a six-month multidrug regimen that comes with potentially adverse side effects. These can result in poor patient adherence to the prescribed treatment, the development of drug resistance, and persistent infection and transmission. To improve adherence and cure rates, it is critical to identify either less toxic drugs or patients who are eligible for better-tailored durations of existing therapies.

Rada Savic and colleagues analyse existing clinical trial data and find that for patients with low-grade TB, four months of drug therapy was as effective as six months of the same treatment. In contrast, the authors find that poor adherence to treatment regimens, HIV co-infection, and high-grade TB infections were associated with poor outcomes and may signal the need for longer duration treatments in such cases. Applied clinically, these findings may accelerate TB cures and reduce global burden of the disease.