TB Therapy: How Short Can We Go?

Treatment strategy as short as 8 weeks was noninferior to the standard 6-month regimen for rifampin-susceptible pulmonary TB — but there are caveats.

While the 6-month regimen of rifampin, isoniazid, pyrazinamide, and ethambutol (RIPE) is highly effective for drug-susceptible pulmonary tuberculosis (TB), maintaining adherence is a challenge that has prompted studies of shorter treatments, including a noninferior 4-month regimen (NEJM JW Infect Dis Jun 2021 and N Engl J Med 2021; 384:1705). Now, researchers have conducted a phase 2–3 open-label noninferiority trial (TRUNCATE-TB) to assess whether even shorter-duration treatment is possible.

They compared RIPE (control) to four different regimens (rifampin-linezolid, rifampin-clofazimine, rifapentine-linezolid, or bedaquiline-linezolid; all given along with isoniazid, pyrazinamide, and ethambutol) administered in a strategy of an initial 8-…

Reviewing Author

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health

Richard T. Ellison III, MD

Disclosures

Consult/Advisory BoardAcurx Pharmaceuticals, LLC;

Grant/Research SupportDoctors Company Foundation, Massachusetts Department of Public Health

TB Therapy: How Short Can We Go?

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Reviewing Author