An innovative new trial aiming to identify new combinations of drugs that could cure tuberculosis (TB) more quickly has just started recruiting patients. The MAMS-TB trial is being carried out by the PanACEA (Pan African Consortium for the Evaluation of Anti-tuberculosis agents) consortium, and will take place in Tanzania and South Africa.
Tuberculosis is a major global health problem, with around 8 million new cases, and more than a million deaths, each year. Currently treatment usually involves taking a combination of drugs for 6 months, which is challenging for both patients and health systems. Developing shorter courses of treatment is a priority.
The trial is the first TB study to use the multi-arm multi-stage (MAMS) design, allowing researchers to test a number of promising approaches at the same time. The design, which was developed by MRC CTU in cancer trials, allows several treatments to be assessed against a single control arm, and those that are not sufficiently promising can be dropped after interim analyses. New treatments that become available after the trial has started can also be added.
The PanACEA consortium has the aim of building a research network that can deliver more effective treatments for TB. The consortium has been able to develop capacity of African centres to tackle tuberculosis through building infrastructure and supporting the professional development of African and European scientists. There are 11 collaborating centres in sub-Saharan Africa and a growing group of European collaborators. Researchers at MRC CTU have adapted this design for use in a TB trial and will be responsible for the interim and final analyses. The consortium is funded by the European Developing Country Clinical Trials Partnership (EDCTP).