The second stage of the STREAM trial has now started, assessing two new courses for the treatment of multi-drug resistant tuberculosis (MDR-TB).
The STREAM study is trying to identify new combinations of drugs that can shorten the duration of treatment and improve outcomes for patients with multi-drug resistance tuberculosis (MDR-TB).
The first stage of the STREAM trial tested a 9-month treatment. This is now in follow-up. The second stage of STREAM, which started recruiting patients in March, is looking at two more combinations of drugs, comparing them to the two combinations used in the first stage of STREAM. Patients joining the trial will be randomly allocated to one of the following groups:
· a fully oral (all tablet) 9-month treatment course, including the a new drug called bedaquiline
· a 6-month treatment course with a shorter initial intensive phase, including bedaquiline
· the 9-month treatment course used in STREAM stage 1, which includes injections
· the standard 20-24 month treatment course recommended by the World Health Organisation
Despite the availability and effectiveness of affordable six-month treatments for drug-sensitive TB, the worldwide control of the disease is currently being impacted by the emergence of MDR-TB.
Currently the standard treatment for MDR-TB offers very poor results with substantial levels of drug side-effects and takes 20-24 months.
STREAM is an international, randomised, controlled trial that is evaluating standardised treatment of anti-tuberculosis drugs for patients with MDR-TB. It is currently taking place in centres across Ethiopia, Mongolia, South Africa and Vietnam and has recruited 424 people to Stage 1.
The trial is being run by researchers based at the MRC Clinical Trials Unit at UCL in collaboration with the International Union Against TB and Lung Disease (the Union).