Public Release: 

Multi-drug-resistant TB cure rates higher than expected

Queen Mary University of London

The Tuberculosis Network Clinical Trials Group (TBNET), an international consortium of clinicians and scientists, documented the management of 380 patients with Multidrug-Resistant Tuberculosis (MDR-TB) at 23 different sites across Europe over five years.

The study, published as correspondence in the New England Journal of Medicine, found that cure rates in Europe were 61 per cent according to TBNET's new definitions, compared to only 31 per cent when using the standard criteria proposed by the WHO.

MDR-TB has been on the increase worldwide over the past decade, with the largest number of patients living in the European WHO region. Despite treatment with expensive drugs, cure rates were thought to be very low.

The WHO definition for 'cured' patients includes having three cultures of sputum (mucus from the respiratory tract) that test negative for MDR-TB, taken at least 30 days apart during the continuation phase of treatment.

The researchers found that the WHO criterion for 'cure' could not be applied in the majority of patients. This was because most patients who had successful treatments did not produce sputum (normally produced as the result of infection) after eight months of therapy and therefore could not give a sample.

TBNET proposed new definitions for 'cure' and 'failure' of MDR-TB treatment based on the sputum culture status at six months after the initiation of therapy, and whether patients were free from disease recurrence one year after the end of therapy.

Dr Heinke Kunst, on behalf of the TB research group at QMUL, said: "The results from our study are very encouraging and may give hope to patients who are affected by MDR-TB. But there is still much to do to improve treatment outcomes, as 30 per cent of MDR-TB patients still cannot be cured in Europe.

"We need new drugs and shorter regimens which are more effective, less toxic and widely available in the European region. We are optimistic that outcomes can be improved with novel medicines and individually-tailored treatments, rather than programmatic one-for-all courses of therapy."

Dr Simon Tiberi (Consultant in Infectious Diseases) was also involved in the study, and Dr Veronica White is TB lead for Barts Health NHS Trust.

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Notes to the editor

Correspondence: 'Treatment Outcomes in Multidrug-Resistant Tuberculosis'. Gunar Günther, Christoph Lange et al. New England Journal of Medicine 2016. DOI: 10.1056/NEJMc1603274

About Queen Mary University of London

Queen Mary University of London (QMUL) is one of the UK's leading universities, and one of the largest institutions in the University of London, with 20,260 students from more than 150 countries.

A member of the Russell Group, we work across the humanities and social sciences, medicine and dentistry, and science and engineering, with inspirational teaching directly informed by our research - in the most recent national assessment of the quality of research, we were placed ninth in the UK (REF 2014).

We also offer something no other university can: a stunning self-contained residential campus in London's East End. As well as our home at Mile End, we have campuses at Whitechapel, Charterhouse Square and West Smithfield dedicated to the study of medicine, and a base for legal studies at Lincoln's Inn Fields.

We have a rich history in London with roots in Europe's first public hospital, St Barts; England's first medical school, The London; one of the first colleges to provide higher education to women, Westfield College; and the Victorian philanthropic project, the People's Palace based at Mile End.

QMUL has an annual turnover of £350m, a research income worth £100m, and generates employment and output worth £700m to the UK economy each year.

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