logo
Science Portal
Copyright © Médecins Sans Frontières
v2.1.5662.produseast1
About MSF Science Portal
About
Contact Us
Frequently Asked Questions (FAQs)
Privacy Policy
Terms of Use
Copyright © Médecins Sans Frontières
v2.1.5662.produseast1
TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis | Collections | MSF Science Portal

Drug-resistant tuberculosis (DR-TB) remains an especially deadly form of the ancient scourge of TB, while current treatments are long, toxic, and ineffective for half of all patients. Aiming to change this unacceptable status quo, in the mid-2010’s MSF and partners launched three clinical trials to test novel regimens containing the first new TB drugs in decades.

On 22 December 2022 the New England Journal of Medicine published findings from TB-PRACTECAL, a three-country randomized controlled trial, showing that a shorter regimen is safer and cured 89% of DR-TB patients, compared with 52% on the standard of care. These findings have already been incorporated into the World Health Organization’s new TB treatment guidelines. A separate study shows that the new regimen is also more cost-effective.

Alongside these results the content collection linked below highlights other aspects of the trial, from community engagement strategies that helped shape TB-PRACTECAL to setbacks arising from the Covid-19 pandemic. It also examines urgent challenges in scaling up access to these life-saving drugs, including affordability and patent barriers.

Collection Content

See more collections

How humanitarian programmes adapted to a respiratory pandemic (MSF Scientific Days International 2022))
How humanitarian programmes adapted to a respiratory pandemic...
No description available
MSF logo
Costs, cost-effectiveness, and financing of tuberculosis trea...

Tuberculosis (TB) is the world's deadliest infectious disease, and the leading killer of people with HIV. TB is curable, but it can be difficult to diagnose and tough to treat, especially for increasingly prevalent drug-resistant TB. In 2023, 22,700 people started TB treatment in MSF programs. Understanding the costs and cost-effectiveness associated with TB treatment and innovations, ranging from TB diagnostics and medications to TB care models, can help to plan resource needs and allocate resources effectively. Analyzing financing mechanisms can support developing sustainable funding models for TB control.

This collection spotlights articles by MSF and collaborators to analyze and document the costs of care, particularly diagnostics and medications.

Safe abortion care at MSF
Safe abortion care at MSF

Unsafe abortion is a major cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 29,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion.


To mark International Safe Abortion Awareness Day (28 September 2024), this Collection presents highlights of MSF’s work on safe abortion care (SAC) as a way to reduce maternal death and injury. By re-assessing and reshaping how our projects deliver SAC in fragile and conflict-affected settings, we have been able to significantly expand services in those contexts and across MSF projects globally. In parallel, we also conducted in-depth studies of abortion complications and their contributing factors in fragile settings, where a dearth of evidence limits understanding of women's needs in accessing comprehensive care. These findings are helping to identify gaps in service delivery and inform operational decision-making.

View All Collections
Journal Article
|
Research

Short oral regimens for pulmonary rifampicin-resistant tuberculosis (TB-PRACTECAL): an open-label, randomised, controlled, phase 2B-3, multi-arm, multicentre, non-inferiority trial

Nyang'wa BT, Berry C, Kazounis E, Motta I, Parpieva N,  et al.
2024-02-01 • Lancet Respiratory Medicine
2024-02-01 • Lancet Respiratory Medicine
BACKGROUND
Around 500,000 people worldwide develop rifampicin-resistant tuberculosis each year. The proportion of successful treatment outcomes remains low and new treatments are nee...
Journal Article
|
Research

A 24-week, all-oral regimen for rifampin-resistant tuberculosis

Nyang'wa BT, Berry C, Kazounis E, Motta I, Parpieva N,  et al.
2022-12-22 • New England Journal of Medicine
2022-12-22 • New England Journal of Medicine
BACKGROUND
In patients with rifampin-resistant tuberculosis, all-oral treatment regimens that are more effective, shorter, and have a more acceptable side-effect profile than current...
Journal Article
|
Research

Cost-effectiveness of short, oral treatment regimens for rifampicin resistant tuberculosis

Sweeney S, Berry C, Kazounis E, Motta I, Vassall A,  et al.
2022-12-07 • PLOS Global Public Health
2022-12-07 • PLOS Global Public Health
Current options for treating tuberculosis (TB) that is resistant to rifampicin (RR-TB) are few, and regimens are often long and poorly tolerated. Following recent evidence from the TB-PR...
Technical Report
|
Policy Brief

DR-TB drugs under the microscope 2022

MSF Access Campaign
2022-11-08
2022-11-08
TB was the leading cause of death from a single infectious agent until the COVID pandemic. The number of people newly diagnosed with TB in 2020 fell by 18% from the previous year due to ...
Journal Blog
|
Perspective

New, shorter treatments for drug resistant TB are a lifeline for people living through conflict

Jain L
2022-06-29 • BMJ Opinion (blog)
2022-06-29 • BMJ Opinion (blog)
Journal Article
|
Research

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

Berry C, du Cros PAK, Fielding K, Gajewski S, Kazounis E,  et al.
2022-06-13 • Trials
2022-06-13 • Trials
BACKGROUND
Globally rifampicin-resistant tuberculosis disease affects around 460,000 people each year. Currently recommended regimens are 9-24 months duration, have poor efficacy and...
Conference Material
|
Video

24-week regimens for treatment of rifampicin-resistant tuberculosis: four-arm randomised trial

Berry C, Motta I, Kazounis E, Fielding K, Dodd M,  et al.
2022-06-07 • MSF Scientific Days International 2022
2022-06-07 • MSF Scientific Days International 2022
No abstract available.
Journal Blog
|
Perspective

6 months TB treatment for (almost) all

Berry C
2022-05-10 • PLoS Blogs
2022-05-10 • PLoS Blogs
Journal Article
|
Research

Optimising recruitment to a late-phase tuberculosis clinical trial: a qualitative study exploring patient and practitioner experiences in Uzbekistan

Wharton-Smith A, Horter SCB, Douch E, Gray NSB, James N,  et al.
2021-12-04 • Trials
2021-12-04 • Trials
BACKGROUND
Addressing the global burden of multidrug-resistant tuberculosis (MDR-TB) requires identification of shorter, less toxic treatment regimens. Médecins Sans Frontières (MSF)...
Journal Article
|
Letter

TB research requires strong protections, innovation, and increased funding in response to COVID-19

Nyang'wa BT, LaHood AN, Mitnick CD, Guglielmetti L
2021-05-29 • Trials
2021-05-29 • Trials
When 2020 opened, approximately 11 million new tuberculosis (TB) cases and nearly 1.5 million TB-related deaths were predicted during the year. And, the gap between required and availabl...
Journal Blog
|
Perspective

Engaging communities in tuberculosis research: The experience of the TB-PRACTECAL trial

Douch E
2018-11-09 • BMJ Opinion (blog)
2018-11-09 • BMJ Opinion (blog)
TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis

TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis