A Stellenbosch University researcher will be at the forefront of a large international study aimed at shortening TB treatment from six months to just four in the majority of patients.
Professor Gerhard Walzl, from the university's faculty of Medicine and Health Sciences, along with Professor Clifton Barry from the US National Institutes of Health, will lead the Predict-TB consortium, which is developing a device that identifies patients whose TB can be cured after just four months of treatment.
Current treatment of TB is long, complicated to administer and can have severe side-
effects.
To prevent recurrence of the disease after treatment is stopped, patients must take a combination of different antibiotics for at least six months.
This often leads to im-
proper adherence, which consequently can result in the development of multidrug-resistant TB (MDR).
Treatment for drug-resistant TB can take up to two years, and is more complex and expensive. Among those who do receive treatment for MDR TB, only 50% survive.
Previous studies of treatment shortening, usually to four months, have all been unsuccessful when compared to standard six-month treatment. Six-month courses cure 95% of patients and shorter courses only 80-85% of patients. This still means, however, that most patients are cured after four months, but experts cannot currently know beforehand which patients belong to that group.
Over the next five years, the consortium will develop a smart set of treatment stopping criteria, and a point-of-care device to measure immunological markers that can contribute to the decision-making.
The group will perform a phase 2B clinical trial in South Africa and China.
Walzl said the group had promising pilot data, which suggested that this initiative could work.
“We are working on the development of tests that are simple and affordable and that can take the place of the expensive PET/CT scanning.
“Early results suggest that this is possible. So, ultimately, we are working towards a finger-stick blood test, similar to a blood glucose test, that would be applied at the beginning of treatment and after four weeks to tell the health care workers if the patient needs to be treated for shorter or longer periods,” Walzl said.
TB treatment in many patients could be shortened and this would lead to cost savings and an earlier return to a normal life for the patient, who would save weeks of directly observed therapy and clinic visits. “Drugs like antibiotics have side-effects and shorter treatment duration would decrease these,” Walzl said.
The Predict-TB project will receive over R277 million in funding from the European and Developing Countries Clinical Trials Partnership, the Bill and Melinda Gates Foundation through the Foundation for the National Institutes of Health, National Institutes of Health, the National Science Foundation of China and China Ministry of Science and Technology.