A new trial looking into whether shorter and more effective treatment is possible for patients suffering from multi-drug resistant tuberculosis (TB) has just opened. The STREAM trial is the first ever international randomised controlled trial of treatment for multi-drug resistant TB to assess long-term outcomes. It will take place in South Africa, Ethiopia, Vietnam and possibly in India. It is expected to recruit at least 400 people.
Highly effective six-month treatment for drug sensitive TB is available. However, strains of TB that are resistant to the key drugs rifampicin and isoniazid are becoming increasingly common and patients with these strains have much poorer outcomes, and require much longer (up to 24 months) treatment. The STREAM trial will test whether a newly developed more intensive 9 month treatment that includes clofazimine and a high dose flouroquinolone is at least as effective as the current longer treatments.
If this trial shows that the new shorter treatment regimen is as effective as current treatment, it will greatly improve the quality of life for those with MDR-TB. A shorter treatment will hopefully improve treatment adherence, which greatly increases a patient’s chances of being cured of MDR-TB, and be simpler for over-burdened treatment services to manage.