Using biomarkers to predict TB treatment duration (Predict TB): a prospective, randomized, noninferiority, treatment shortening clinical trial
- Chen, RY
- Via, LE
- Dodd, LE
- Walzl, G
- Malherbe, ST
- Loxton, AG
- Dawson, R
- Wilkinson, RJ
- Thienemann, F
- Tameris, M
- Hatherill, M
- Diacon, AH
- Liu, X
- Xing, J
- Jin, X
- Ma, Z
- Pan, S
- Zhang, G
- Gao, Q
- Jiang, Q
- Zhu, H
- Liang, L
- Duan, H
- Song, T
- Alland, D
- Tartakovsky, M
- Rosenthal, A
- Whalen, C
- Duvenhage, M
- Cai, Y
- Goldfeder, LC
- Arora, K
- Smith, B
- Winter, J
- Barry Iii, CE
- Predict TB Study Group
DOIAbstract
Background : By the early 1980s, tuberculosis treatment was shortened from 24 to 6 months, maintaining relapse rates of 1-2%. Subsequent trials attempting shorter durations have failed, with 4-month arms consistently having relapse rates of 15-20%. One trial shortened treatment only among those without baseline cavity on chest x-ray and whose month 2 sputum culture converted to negative. The 4-month arm relapse rate decreased to 7% but was still significantly worse than the 6-month arm (1.6%, P<0.01). We hypothesize that PET/CT characteristics at baseline, PET/CT changes at one month, and markers of residual bacterial load will identify patients with tuberculosis who can be cured with 4 months (16 weeks) of standard treatment.Methods: This...
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