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New tools and approaches to drug-resistant TB | Collections | MSF Science Portal

The World Health Organization estimates that 410,000 people developed a drug-resistant tuberculosis infection (DR-TB) in 2022, only 40% of whom were diagnosed and started on treatment—and only 63% then cured. Given all these points of failure, innovation in preventing, diagnosing and treating DR-TB cannot come fast enough.

To mark World TB Day (24 March 2024) the content collection linked below highlights recent work by MSF and collaborators to help change this grim picture. The TB-PRACTECAL and endTB studies delivered robust evidence for shorter, safer, more effective drug regimens that are already saving lives worldwide. Other studies explore new approaches to preventive treatment and simpler, quicker, accurate detection of TB and drug resistance—especially among difficult-to-diagnose populations such as children and people living with HIV.

But to impact DR-TB globally these innovations must become widely accessible. This requires changes on many fronts, as described in an accompanying Collection (Expanding Access to Lifesaving New TB Tools).

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TB Union Conference 2022
TB Union Conference 2022
Innovation in preventing, diagnosing and treating drug-resistant tuberculosis (DR-TB) cannot come fast enough—especially given the ground lost due to the Covid-19 pandemic, and with only 1 in 3 people who have DR-TB now receiving care. The content collection linked below offers a snapshot of recent TB work by MSF and collaborators to help change this picture. The TB-PRACTECAL and endTB studies have delivered clear evidence for shorter, safer, more effective treatments against drug-resistant (DR)-TB. Faced with the many hurdles that lie ahead before these and other critical interventions can be widely accessible, other studies investigate patient/family-based models of care adapted to complex settings and neglected groups, including children. Last, several authors explore limited but potentially important options for expanding diagnosis and preventive treatment.
TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis
TB-PRACTECAL Trial—Evidence for a shorter, safer, more effect...
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.
MSF Scientific Days International 2024
MSF Scientific Days International 2024
On 16 May people from within and outside MSF will gather in London, joined by online participants from over 100 countries, for this annual ‘conference without borders’ showcasing medical research from fragile and conflict affected settings. All too often the populations MSF and others work with are excluded from the benefits of research. Yet they are the ones that often need these benefits most. So speakers will consider how MSF’s research has impacted the way our projects deliver care, how knowledge gaps can be pivotal to political gatekeeping and to triggering appropriate humanitarian responses, and how identifying best practices and funding innovation are key to improving our capacity to act. Here you can view abstracts for all scientific presentations, which focus on infectious diseases, outbreaks, vaccination, and mortality.
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Journal Article
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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
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Research

Nine-month, all-oral regimens for rifampin-resistant tuberculosis

Guglielmetti L, Khan U, Velasquez GE, Gouillou M, Abubakirov A,  et al.
2024-01-29 • medRxiv
2024-01-29 • medRxiv

BACKGROUND

Aft...

Journal Article
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Research

Detection of Mycobacterium tuberculosis complex using the Xpert MTB/RIF Ultra assay on the stool of pediatric patients in Dushanbe, Tajikistan

Rekart ML, Mun L, Aung A, Gomez D, Mulanda WK,  et al.
2023-01-09 • Microbiology Spectrum
2023-01-09 • Microbiology Spectrum
We report the findings of a prospective laboratory diagnostic accuracy study to evaluate the sensitivity, specificity, and predictive values of the Xpert MTB/RIF Ultra assay for Mycobact...
Conference Material
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Slide Presentation

Pregnancy outcomes in patients undergoing drug-resistant tuberculosis treatment in two closely monitored cohorts

Lachenal N, Hewison CCH, Berry C, Mitnick CD, Ahmed SM,  et al.
2022-05-11 • MSF Scientific Days International 2022
2022-05-11 • MSF Scientific Days International 2022
Conference Material
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Abstract

Can point-of-care ultrasound support tuberculosis diagnosis in children? The experience of MSF in Guinea-Bissau

Moreto-Planas L, Sagrado MJ, Mahajan R, Gallo J, Biague E,  et al.
2022-05-11 • MSF Scientific Days International 2022
2022-05-11 • MSF Scientific Days International 2022
INTRODUCTION
Tuberculosis (TB) is an important cause of morbidity and mortality in children and over 50% of childhood TB remains undiagnosed every year. As microbiological confirmati...
Journal Article
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Commentary

Being heard on all-oral therapy for resistant tuberculosis

Furin J, Isaakidis P
2022-05-02 • Lancet Infectious Diseases
2022-05-02 • Lancet Infectious Diseases
Journal Article
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Research

Feasibility and acceptability of using the novel urine-based FujiLAM test to detect tuberculosis: A multi-country mixed-methods study

Rucker SCM, Lissouba P, Akinyi M, Lubega AV, Stewart RC,  et al.
2022-05-01 • Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
2022-05-01 • Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
BACKGROUND
The novel urine-based FujiLAM test identifies tuberculosis in HIV-positive patients but may be challenging to use at point-of-care (POC).

OBJECTIVES
We assess...
Journal Article
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Research

Whole genome sequencing has the potential to improve treatment for rifampicin-resistant tuberculosis in high burden settings: a retrospective cohort study

Cox HS, Goig GA, Salaam-Dreyer Z, Dippenaar A, Reuter A,  et al.
2022-02-16 • Journal of Clinical Microbiology
2022-02-16 • Journal of Clinical Microbiology
BACKGROUND
Treatment of multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB), although improved in recent years with shorter, more tolerable regimens, remains largely...
Journal Article
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Commentary

Tuberculosis preventive therapy for children and adolescents: an emergency response to the COVID-19 pandemic

Mohr-Holland E, Douglas-Jones B, Apolisi I, Ngambu N, Mathee S,  et al.
2021-03-01 • Lancet Child and Adolescent Health
2021-03-01 • Lancet Child and Adolescent Health
Journal Article
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Commentary

Introducing new and repurposed TB drugs: the endTB experience

Seung KJ, Khan UT, Varaine FFV, Ahmed SM, Bastard M,  et al.
2020-10-01 • International Journal of Tuberculosis and Lung Disease
2020-10-01 • International Journal of Tuberculosis and Lung Disease
In 2015, the initiative Expand New Drug Markets for TB (endTB) began, with the objective of reducing barriers to access to the new and repurposed TB drugs. Here we describe the major imp...
New tools and approaches to drug-resistant TB

New tools and approaches to drug-resistant TB