Pyrazinamide

THURSDAY, Feb. 6, 2025 -- Three all-oral shortened regimens have noninferior efficacy compared with standard therapy for fluoroquinolone-susceptible, rifampin -resistant tuberculosis , according to a study published in the Jan. 30 issue of the New England Journal of Medicine . Lorenzo Guglielmetti, M.D., Ph.D., from Médecins Sans Frontières in Paris, and colleagues conducted a phase 3, multinational, noninferiority trial to compare standard therapy for treatment of fluoroquinolone-susceptible, rifampin-resistant tuberculosis to five nine-month oral regimens, including combinations of bedaquiline (B), delamanid (D), linezolid (L), levofloxacin (Lfx) or moxifloxacin (M), clofazimine (C), and pyrazinamide (Z). A total of 754 participants were randomly assigned to one of five combinations or standard therapy; 699 were included in the modified intention-to-treat analysis and 562 were included in the per-protocol analysis. The primary end point was a favorable outcome at week 73, defined by two negative sputum culture results or favorable bacteriologic, clinical, and radiologic evolution. The noninferiority margin was −12 percentage points. The researchers found that 80.7 percent of the patients in the standard-therapy group had favorable outcomes in the modified intention-to-treat analysis. In the modified intention-to-treat population, the risk difference between standard therapy and each of the four new regimens was noninferior: 9.8, 8.3, 4.6, and 2.5 percentage points for BCLLfxZ, BLMZ, BDLLfxZ, and DCMZ, respectively. In the per-protocol population, the differences were similar, apart from DCMZ, which was not noninferior. Across the regimens, the proportion of participants with grade 3 or higher adverse events was similar. "The results of this trial support the noninferior efficacy of three all-oral shortened regimens for the treatment of rifampin-resistant tuberculosis," the authors write. Two authors disclosed ties to the biopharmaceutical industry. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

TUESDAY, Jan. 28, 2025 -- Kansas health officials are fighting the largest tuberculosis (TB) outbreak in U.S. history, with 67 confirmed cases since new year began. The outbreak includes 60 active cases in Wyandotte County and seven in Johnson County, according to the Kansas Department of Health and Environment (KDHE). That's the most since the 1950s, when the U.S. Centers for Disease Control and Prevention (CDC) began monitoring and reporting TB cases. Health officials are testing and treating affected individuals. "While there is a very low risk of infection to the general public in these communities, KDHE is working to ensure that patients are receiving appropriate treatment, which will limit the ability to spread this disease and prevent additional cases from occurring," KDHE spokeswoman Jill Bronaugh told the University of Minnesota's CIDRAP News in an email. "This outbreak is still ongoing, which means that there could be more cases." TB is caused by a bacterium called Mycobacterium tuberculosis, according to the CDC. It spreads through the air when someone with active TB disease coughs or speaks. People who spend time in close contact with someone who has active TB are at greatest risk of infection. TB typically affects the lungs but can also harm the brain, kidneys or spine. Here are the two forms : Kansas health officials are regularly screening anyone who tests positive to determine whether they have latent TB infection or active TB. Treatment for latent TB typically involves one or more medications, such as isoniazid or rifampin , for up to nine months. Active TB typically requires a longer treatment course with combinations of drugs, including ethambutol , rifampin and pyrazinamide . Although a TB vaccine exists (Bacille Calmette-Guérin), it is not commonly used in the U.S., the CDC said. Certain groups face a higher risk of TB , including people who: Local health departments in Kansas are conducting free testing for individuals, regardless of insurance coverage. SOURCES: Kansas Department of Health and Environment (KDHE), news release, Jan. 24, 2025; University of Minnesota CIDRAP News, news release, Jan. 27, 2025, USA Today , media report, Jan. 27, 2025 If you live in Kansas, especially in Wyandotte or Johnson County, consider getting tested for TB if you are at risk or have symptoms. Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.