Four-dose TB drug regimen comparable to higher dose regimens

A  study published in the April 13 issue of JAMA reports that newly diagnosed tuberculosis patients who received a four-drug fixed-dose regimen were found to have comparable results to those who had more drugs administered separately.

The fixed-dose combinations can reduce the risk of incorrect dosage, simplify drug procurement and aid in ensuring adherence, according to the report.

The study, headed by Dr. Christian Lienhardt from the Clinical Trial Division at the International Union Against Tuberculosis and Lung Disease, was conducted at 11 sites in Africa, Asia and Latin American between 2003 and 2008.

During the eight-week intensive phase of treatment, nearly half of the 1,585 adult patients with newly diagnosed smear-positive pulmonary tuberculosis used for the study were given the four-drug - rifampicin, isoniazid, pyrazinamide, ethambutol - treatment, while the other group received their drugs separately.

Eighteen months from the start of the treatment, the analysis yielded positive results. In one of the models, researchers found that 83.3 percent of the patients in the FDC group had a favorable outcome compared to the 84.8 percent favorable outcome in the separate-drugs group.

Regardless of these results, the researchers acknowledge that the use of FDCs is still being met with some reluctance from those who have doubts about their efficacy, quality and access.  

If  FDCs are adopted as an alternative treatment, patients would take three to four pills instead of the nine to 16 per day in the intensive phase, the report found.