Treatment of Drug Resistant TB

The TBPod

Drug Resistant TB is a growing problem with some exciting advances over the past decade. With the recent Rapid Communication from the WHO and the advent of the B-PALMS regimen, drug resistant TB is a changing and exciting field of tuberculosis around the world.
In this episode Professor Greg Fox from the University of Sydney speaks with Dr Jack Callum about the latest changes in the treatment of Drug Resistant TB in light of the WHO Rapid Communication as well as the NIX, ZeNIX and TB Practecal Trials. Professor Fox also addressing the implications for clinical practice and what the future might hold in this ever challenging field of TB.

REFERENCES:

1) Gegia, Medea, et al. "Treatment of isoniazid-resistant tuberculosis with first-line drugs: a systematic review and meta-analysis." The Lancet Infectious Diseases 17.2 (2017): 223-234.

2) NIX Study: Conradie, Francesca, et al. "Treatment of highly drug-resistant pulmonary tuberculosis." New England Journal of Medicine382.10 (2020): 893-902.

3) ZeNIX Study: Conradie, Francesca, et al. "Bedaquiline–pretomanid–linezolid Regimens for drug-resistant tuberculosis." New England Journal of Medicine 387.9 (2022): 810-823.

4) TB Practecal Trial (not yet published but study protocol available): Berry, Catherine, et al. "TB-PRACTECAL: study protocol for a randomised, controlled, open-label, phase II–III trial to evaluate the safety and efficacy of regimens containing bedaquiline and pretomanid for the treatment of adult patients with pulmonary multidrug-resistant tuberculosis." Trials 23.1 (2022): 1-16.

5) WHO Guidelines for DR TB Update: World Health Organization. Rapid communication: key changes to the treatment of drug-resistant tuberculosis. No. WHO/UCN/TB/2022.2. World Health Organization, 2022.
6) Commentary on the WHO Update: Migliori, G. B., and S. Tiberi. "WHO drug-resistant TB guidelines 2022: what is new?." The International Journal of Tuberculosis and Lung Disease: the Official Journal of the International Union Against Tuberculosis and Lung Disease26.7 (2022): 590-591.