EndTB Clinical Trial Reveals Promising Paths for Tuberculosis Treatment

New treatment possibilities for tuberculosis, presented this week in Paris, offer hope for individuals with severe forms of the disease. Current treatments for drug-resistant tuberculosis, affecting those unresponsive to standard drugs, come with severe side effects and require the ingestion of thousands of tablets over one or two years. In 2022, 175,000 newly diagnosed individuals received these burdensome treatments, out of an estimated 410,000 new cases globally, resulting in 1.3 million deaths, primarily in low- and middle-income countries. The research, ongoing for years, seeks more effective, shorter, and better-tolerated treatments. Notably, the EndTB clinical trial presented groundbreaking findings at the Global Conference on Lung Health in Paris on September 15, introducing new drug combinations and a promising molecule under development.

Launched in 2017, the EndTB trial, organized by Médecins Sans Frontières, Partners In Health, and the Institute for Research Development in Dubai, aimed to establish the efficacy of new drug combinations compared to WHO-approved standard treatments. Among the tested combinations, three showed superior efficacy rates ranging from 85.2% to 90.4%, surpassing the reference treatment (80.7%). The trial, increasing the range of available tools, emphasizes the importance of offering different combinations for individual patient needs. Additionally, the research addresses the neglected area of pediatric tuberculosis pharmacoresistance. These discoveries, presented at the conference, mark a significant step forward, reinforcing the commitment to changing the landscape of tuberculosis treatment.

The EndTB trial, part of drug repositioning strategies, complements traditional drug development approaches. The conference also featured the introduction of TBAJ-876, a molecule developed by the TB Alliance, exhibiting ten times greater efficacy than the established drug. While TBAJ-876 is still in the early stages of development, the combinations showcased in the EndTB trial are already available. The hope is that the World Health Organization officially recommends these new combinations by the first quarter of 2024, although challenges, particularly regarding the cost of certain components like delamanide, must be addressed for successful implementation. Lorenzo Guglielmetti, the project director at Médecins Sans Frontières, sees these innovations as a transformative window for addressing the historically neglected issue of tuberculosis.

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