Short-course treatment for multidrug-resistant tuberculosis: the STREAM trials.

Short-course treatment for multidrug-resistant tuberculosis: the STREAM trials.
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DOI:
10.1183/16000617.0080-2015
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发表时间:
2016-03
期刊:
European respiratory review : an official journal of the European Respiratory Society
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耐多药(MDR)结核病(TB)是对全球结核病控制的一个威胁,因为次优和耐受性差的治疗方案已导致这些患者的结果基本不利。在孟加拉国进行的六项队列研究中的最后一项研究评估了使用现有结核病药物的新的较短治疗方案,结果令人鼓舞,并提供了比世界卫生组织(世卫组织)推荐的方案更可接受和更有效的治疗方案的可能性。STREAM(耐多药结核病患者抗结核药物标准化治疗方案评价)试验第1阶段的目的是评价该方案与世卫组织推荐的现行标准治疗方案相比的疗效和安全性。第2阶段评价了两种新的含贝达喹啉方案:一种是全口服方案,第二种是第1阶段研究方案的进一步缩短和简化版本,将每种方案的疗效和安全性与第1阶段研究方案以及WHO推荐的标准治疗进行比较。第1阶段研究方案的成功很可能为耐多药结核病患者提供新的治疗标准,而第2阶段含贝达喹啉方案的阳性结果可能使这一困难人群的管理取得更大进展。STREAM试验的综述,该试验评估了耐多药结核病新治疗方案的安全性和有效性http://ow.ly/VtVkQ
Multidrug-resistant (MDR) tuberculosis (TB) is a threat to global TB control, as suboptimal and poorly tolerated treatment options have resulted in largely unfavourable outcomes for these patients. The last of six cohort studies conducted in Bangladesh which assessed a new shorter regimen using currently available TB drugs showed promising results and offered the possibility of a more acceptable and more effective regimen than the one recommended by the World Health Organization (WHO). The aims of stage 1 of the STREAM (Evaluation of a Standardised Treatment Regimen of Anti-tuberculosis Drugs for Patients with Multidrug-resistant Tuberculosis) trial are to evaluate the efficacy and safety of this regimen, compared to the current WHO-recommended standard of care. Stage 2 evaluates two new bedaquiline-containing regimens: one an all-oral regimen and the second a further shortened and simplified version of the stage 1 study regimen, comparing the efficacy and safety of each to that of the stage 1 study regimen and also to the WHO-recommended standard of care. Success of the stage 1 study regimen would in all probability provide a new standard of care for MDR-TB patients, while positive results from the bedaquiline-containing regimens in stage 2 may allow for even greater progress in the management of this difficult population. A review of the STREAM trial, which evaluates the safety and efficacy of new treatment regimens for MDR-TB http://ow.ly/VtVkQ
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