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Wednesday, May 1st, 2024

Shorter treatment time possible for pulmonary tuberculosis

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A study published in Nature Medicine this week revealed that nearly half of tuberculosis (TB) diagnosed patients each year could potentially be cured with treatments shorter than those recommended.

Specifically, the study examined three TB trials previously thought to disprove the efficacy of four-month vs. six-month treatments. It was led by a student from UC San Francisco with assistance from colleagues at the University of Liverpool, London School of Hygiene and Tropical Medicine, the Critical Path Institute, Bill & Melinda Gates Foundation, Aurum Institute, Case Western University, and the World Health Organization. Yet scientists discovered the reason those tests failed was due to a faulty treatment plan that saw all patients treated the same, regardless of disease severity.

By contrast, when modern scientists broke the analysis of these tests into categories of severity, the four-month drug regimens turned out to be quite effective for those with minimal cases of the disease. It remains ineffective for those with moderate or severe cases, however, and even the six-month treatment could not help those with the most extensive samples of TB.

“Our study shows a stratified medicine approach can be feasibly applied to achieve treatment shortening for many patients with TB,” Dr. Payam Nahid, professor of medicine in the Division of Pulmonary and Critical Care at UCSF School of Medicine, and one of the first authors of the paper said. “A one-size-fits-all approach leads to undertreatment of patients with severe forms of disease, and overtreatment, with the potential that the drugs will cause harm, for patients who have less extensive disease.”

Almost half of TB patients could be cured with the shorter treatment regimen. However, the study also found that patients cannot miss doses of the medication as even one missed dose can result in a greater risk of failure.

Around 1.3 million people died from TB last year alone, according to the study report.