Drug cocktail raises hope for sufferers

PUBLISHED : Tuesday, 20 March, 2012, 12:00am
UPDATED : Tuesday, 20 March, 2012, 12:00am


In an ambitious effort to stem the deadly tide of TB and deadly multidrug-resistant TB (MDR-TB) around the world, international non-profit organisation TB Alliance yesterday launched a clinical trial to test a novel drug combination in both patients with TB and MDR-TB.

The announcement comes ahead of World TB Day on Saturday.

TB cases and deaths have been falling in the past 50 years or so, but the infectious disease remains a problem particularly in the Western Pacific region, of which Hong Kong is part.

The World Health Organisation's most recent estimates show 1.9 million TB cases and 260,000 deaths each year in the region. Cambodia, China, the Philippines and Vietnam are among the 22 high-burden countries globally, and account for 93 per cent of the regional caseload. Globally, there are 1.4 million deaths and nine million new cases a year.

The TB epidemic tends to be concentrated in vulnerable and marginalised populations, but the situation is made worse by TB-HIV co-infection and the emergence and spread of drug-resistant TB, particularly MDR-TB. The region faces 120,000 incident MDR-TB cases annually, which equals 28 per cent of the world's MDR-TB burden.

There were 4,926 new cases and 183 deaths in Hong Kong last year. Of these, 0.7 per cent of new TB cases and 2.6 per cent of retreatment TB cases were MDR-TB, according to WHO figures.

Dr Mel Spigelman, president and CEO of TB Alliance, says the novel drug regimen being tested is 'a step towards erasing the distinction between TB and MDR-TB - and in the process, dramatically shortening, simplifying and improving treatment'. Currently, a TB patient must take a course of drugs daily for six months, while MDR-TB patients must take a daily injection for the first six months and a dozen or more pills each day for 18 months or more.

Around the world, many patients fail to complete treatment because they can no longer tolerate the side effects of the medication or fail to adhere to the long treatment, leading to drug resistance, be it MDR-TB or even extensively drug-resistant TB (XDR-TB).

The new, completely oral regimen being tested could increase treatment efficacy, lower the cost, and reduce treatment time by more than 80 per cent (to as little as four months in patients with TB and some forms of the drug-resistant strain).

The clinical trial will treat patients for two months and take place at eight sites in South Africa, Tanzania and Brazil. There are many different drug-resistant patterns of TB, and often, due to the unavailability of accurate testing, many health care providers cannot identify the correct form of the disease, leading to improper treatment. Completely novel regimens, with little or no pre-existing resistance, would be effective against all forms of the disease.