The World Health Organization (WHO) has published new recommendations that seek to speed up detection and enhance cure rates for patients with multidrug resistant tuberculosis (MDR-TB).
The WHO recommends the use of a shorter and cheaper treatment regimen, which is taken for 9–12 months, compared to the conventional and more costly treatment regimens, which are taken for 18–24 months.
“This we consider a critical step forward,” Mario Raviglione, director of WHO’s global tuberculosis (TB) programme, told reporters at a news conference on 12 May 2016.
Philippp du Cros, an infectious disease specialist with MÃ©decins San FrontiÃ¨res, says WHO’s recommendations were “a positive step”, adding that countries should waste no time in putting them into practice.
The new regimen comprises seven drugs: kanamycin, moxifloxacin, prothionamide, clofazimine, pyrazinamide, high-dose isoniazid and ethambutol.
Raviglione said that studies of patients with uncomplicated MDR-TB, which is not resistant to second-line TB drugs, resulted in cure rates of 79–87% compared to 50% for the normal regimen.
The shorter drug regimen is estimated to cost less than $1,000 per patient, up to three times cheaper than the normal regimen at $1,500-$3,000.
The shorter regimen is recommended for approximately 70% of the people with MDR-TB, but it can’t be used in patients with second-line drug resistance, extrapulmonary disease and pregnancy.
To help identify patients eligible for the shorter therapy, the WHO has recommended the use of a novel DNA diagnostic test called MTBDRsI, which identifies MDR-TB strains resistant to second-line TB drugs within 24–48 hours, down from the three months at present.
The WHO says an estimated 480,000 people developed MDR-TB in 2014 – about 5% of all TB cases – and 190,000 died from it.