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New drugs trials could slash treatment times

The current incidence and prevalence of tuberculosis are severely straining the capacity of some National Tuberculosis Control Programmes to successfully administer the WHO recommended standard six-month regimen.

Trials of a new drug combination to treat tuberculosis could cut the length of time patients have to take their medicine by a third.

Researchers at St George’s, University of London, hope that speeding up the treatment will help to reduce the 20 million cases of the disease that exist globally – many caused by patients abandoning their medication halfway through because of the long trek to a treatment centre or at the first signs it is working.

In the four-year trial, a high dose of antibiotic drug rifapentine and a broad-spectrum antibiotic, called moxifloxacin, will be given once a week to patients with pulmonary TB in Mozambique, Zambia, Zimbabwe and South Africa. Both rifapentine and moxifloxacin are already used in the treatment of TB, though not in combination. It is hoped that RIFAQUIN, as the new combination is called, will cut the treatment time from six to four months.

Dr. Stanley Mungofa, the Head of the Harare City Health Department, Harare, Zimbabwe, and an investigator in the RIFAQUIN trial, said: “TB treatment just like treatment for chronic diseases tends to be difficult for both the patient and the health system given the fact that when patients feel better they confuse better for cure and abandon their treatment.

“If treatment becomes shorter there is a better chance of them finishing their medication and being cured.”

The trial will start in July 2007and is being carried out by INTERTB, an international consortium of scientists coordinated by Dr Amina Jindani at St George’s, University of London. Professor Denis Mitchison, who successfully pioneered the reduction of treatment from 18 to six months, and Dr Tom Harrison are also on the St George’s INTERTB team.

Dr Jindani said: ‘The development of a new anti-tuberculosis drug could take 15 years and the cost estimated by the Stop TB partnership is almost 5 billion US dollars. By testing a new combination of drugs we already use we can cut that development time by 10 years at a far lower cost.’

The trial has already attracted grants of €4,281,991 (£2.855million) from the European & Developing Countries Clinical Trials Partnership (EDCTP) and a further £200,000 from the Wellcome Trust.

INTERTB is organising a one-day meeting to discuss the contribution of UK researchers to reduce TB treatment duration. The meeting will be held at St. George’s, University of London, on Thursday 22nd March, 2007 and will be attended by researchers in the United Kingdom as well as donor agencies, NGOs and members of the All Party Parliamentary Working Group on TB.

Tamsin Starr | alfa
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