ATS Welcomes Decision on Shorter MDR-TB Regimen

On May 12, the World Health Organization released recommendations aimed to speed up detection and improve treatment outcomes for multidrug resistant tuberculosis (MDR-TB) through the use of a novel, rapid diagnostic test and a shorter, cheaper treatment regimen.

The American Thoracic Society welcomes the WHO’s recently released recommendations, which shorten treatment to nine to 12 months, making it easier for patients to complete treatment. The recommended conventional MDR-TB regimen involves 18 to 24 months of daily therapy, making it challenging for patients to complete.

“The new WHO-recommended MDR-TB treatment regimen is a significant advance for many patients with MDR-TB who will no longer have to endure almost two years of treatment and harsh drug side effects,” says ATS Past President Philip C. Hopewell, MD, professor of medicine and director of the Curry International Tuberculosis Center at the University of California, San Francisco. “Though the new regimen will ease treatment for some MDR-TB patients, there remains an urgent need for shorter, easier treatment for all patients with drug-susceptible and drug-resistant TB, faster point-of-care diagnostics, and effective vaccines to prevent TB in all populations.”

According to the WHO, tuberculosis is a top infectious disease killer worldwide. It notes these staggering statistics:

  • In 2014, 9.6 million people fell ill with TB, and 1.5 million died from the disease.
  • More than 95 percent of TB deaths occur in low- and middle-income countries, and it is among the top five causes of death for women aged 15 to 44.
  • In 2014, an estimated 1 million children became ill with TB and 140,000 children died of TB.
  • TB is a leading killer of HIV-positive people: In 2015, one in three HIV deaths was due to TB.
  • The WHO’s Millennium Development Goal target of halting and reversing the TB epidemic by 2015 has been met globally. According to the WHO:
  • TB incidence has fallen an average of 1.5 percent per year since 2000, and is now 18 percent lower than the level of 2000.
  • The TB death rate dropped 47 percent between 1990 and 2015.
  • An estimated 43 million lives were saved through TB diagnosis and treatment between 2000 and 2014.

Ending the TB epidemic by 2030 is among the health targets of the newly adopted Sustainable Development Goals.

“The battle against TB must be prioritized if we are to halt this pandemic,” says Dr. Hopewell, co-chair of the committee for the WHO International Standards for Tuberculosis Care (third edition, published in 2014), and a member of the ATS Assembly on Microbiology, Tuberculosis & Pulmonary Infections.

For Dr. Hopewell, the ATS is well positioned to advocate for research that leads to the eradication of tuberculosis.

“The ATS is the organization with the most experience in dealing with TB, both as a clinical and a public health problem. We were founded by a group of physicians who were directors of TB sanatoria and hospitals back in 1905, and that progressively broadened to include all of respiratory disease,” Dr. Hopewell says.

In addition to several poster presentations on TB, a symposium on Wednesday will examine “New Concepts in TB Immunity and Targets for Treatment” from 9 to 11 a.m. in the Moscone Center, Room 3016/3018, (West Building, Level 3).

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