New Hope in Fight Against Drug-Resistant Tuberculosis
January 29, 2025
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Tuberculosis (TB), one of the leading infectious disease killers worldwide, has long posed a challenge, particularly with the rise of drug-resistant forms.
However, new research offers fresh hope in the battle against this global health crisis.
An international clinical trial has uncovered three highly effective drug regimens for treating TB resistant to rifampin, the most potent first-line antibiotic used for TB treatment.
These findings, published in the New England Journal of Medicine, are set to transform how we approach the treatment of drug-resistant TB.
A close-up of Mycobacterium tuberculosis, the bacteria responsible for causing TB. A close-up of Mycobacterium tuberculosis, the bacteria responsible for causing TB. iLexx/Getty
Why It Matters
TB is a major global health challenge, responsible for the deaths of more than 1 million people in 2023 alone. The World Health Organization (WHO) estimates that about 410,000 people globally develop drug-resistant TB each year, with many of these cases going undiagnosed or untreated.
The new treatment regimens found in the endTB trial could change the outlook for these patients, with success rates ranging between 85–90 percent in comparison to 81 percent for the control group.
These results are especially significant because they involve fewer side effects, shorter treatment durations and affordability, offering hope for better patient outcomes.
What To Know
The new regimens, discovered through the endTB clinical trial, offer promising solutions for people suffering from TB resistant to rifampin, a strain that has become increasingly difficult to treat.
The trial tested five all-oral, nine-month regimens that combine two new drugs—bedaquiline and delamanid—with older medications. Three regimens were considered successful, performing at least as well as the control group.
Unlike older treatments, which required daily injections and long treatment durations, these new combinations are entirely pill-based and can be tailored to the individual patient’s needs, minimizing side effects and making treatment more accessible.
The endTB trial enrolled 754 patients across seven countries, including Georgia, India, Kazakhstan, Lesotho, Pakistan, Peru and South Africa.
A map showing where the clinical trials were conducted across the globe to find new treatments for drug-resistant tuberculosis. A map showing where the clinical trials were conducted across the globe to find new treatments for drug-resistant tuberculosis. JAKE MILLER/HMS
Participants included a diverse range of individuals, such as children and those infected with HIV or hepatitis C, groups that are often excluded from clinical trials. Pregnant women who became pregnant during treatment were also included.
These three newly identified regimens have already been added to the WHO’s list of recommended treatment options for drug-resistant TB following the publication of a special report in August 2024.
What People Are Saying
Carole Mitnick, the trial’s co-principal investigator, said in a statement: “This Harvard-led partnership among NGOs, ministries of health, and other academic partners identified three new regimens that will make lifesaving care dramatically more accessible.
“We also resolved a critical question left open by pharmaceutical industry trials that brought bedaquiline and delamanid to market: How can these new drugs be used to shorten and simplify treatment while retaining efficacy?”
What Happens Next
As these three new regimens are added to global treatment guidelines, the next steps will focus on ensuring their widespread availability and accessibility.
“The results of the endTB trial improve prospects for effective, simple, all-oral treatment for adults and children with this disease,” the authors wrote.
Is there a health problem that’s worrying you? Do you have a question about tuberculosis? Let us know via health@newsweek.com. We can ask experts for advice and your story could be featured in Newsweek.
References
Guglielmetti, L., Khan, U., Velásquez, G. E., Gouillou, M., Abubakirov, A., Baudin, E., Berikova, E., Berry, C., Bonnet, M., Cellamare, M., Chavan, V., Cox, V., Dakenova, Z., de Jong, B. C., Ferlazzo, G., Karabayev, A., Kirakosyan, O., Kiria, N., Kunda, M., … Mitnick, C. D. (2025). Oral Regimens for Rifampin-Resistant, Fluoroquinolone-Susceptible Tuberculosis. New England Journal of Medicine. https://dx.doi.org/10.1056/NEJMoa2400327
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