Nav: Home

Latent TB treatment: Shorter is better

August 01, 2018

Montreal, Aug. 1, 2018 - Treatment of latent tuberculosis is set to transform after a pair of studies from the Research-Institute of the McGill University Health Centre (RI-MUHC) revealed that a shorter treatment was safer and more effective in children and adults compared to the current standard. These findings are published today in the New England Journal of Medicine.

Led by Dr. Dick Menzies, the study followed 850 children and 6,800 adults with latent TB, a dormant version of the disease that does not cause symptoms but may lead to serious illness if treatment is not provided. This study in children is one of the largest for a pediatric clinical trial related to TB.

Dr. Menzies' team compared results among latent TB patients who underwent the current standard treatment of nine months of isoniazid (INH) or a four-month treatment with rifampin. Over 85 per cent of children completed rifampin without developing active TB compared to 76 per cent of children who completed isoniazid, with two developing active TB. Results were similar in adults; acceptance and completion of rifampin therapy was much better with significantly fewer serious side effects, particularly drug induced hepatitis (INH can cause serious liver toxicity which can prove fatal or require a liver transplant).

In addition to being a much shorter treatment, the rates of development of active TB were slightly lower with rifampin, indicating that it is at least as effective as the nine-month treatment of INH in preventing TB.

"This four-month therapy is a fundamental game-changer in TB prevention," says Dr. Menzies, who is a respirologist with the MUHC and a professor of Medicine, Epidemiology and Biostatistics at McGill University. "The four month treatment was as effective in preventing TB, safer and more acceptable. We believe this four month rifampin treatment should replace the nine months on INH for most people who need therapy for latent TB."

With patients who originated from nine different countries (Australia, Benin, Brazil, Canada, Ghana, Guinea, Indonesia, Saudi Arabia and South Korea) in a study supported by the Canadian Institutes of Health Research, Dr. Menzies expects the findings to have a major impact on shaping future global guidelines related to treating latent TB.

"These discoveries will fuel a new look at global practices," says Dr. Menzies, who has acted as an advisor to the Public Health Agency of Canada, Citizenship and Immigration Canada, the Centres for Disease Control (CDC), and the World Health Organization (WHO) on TB. "We expect this discovery to have a substantial impact on TB, which remains the number one infectious disease killer globally, causing more deaths than AIDS, malaria, diarrhoeal diseases, or other tropical illnesses."

Treatment of latent TB infection is a key part of the End TB strategy & TB-elimination plans in high-income countries from the WHO. One-quarter of the global population is infected with latent TB and 10 per cent of these will develop active TB.
-end-
About the Study

The study 'Safety and Side Effects of Rifampin versus Isoniazid in Children' was authored by Dr. Dick Menzies, DOI: 10.1056/NEJMoa1714284. The study 'Four Months of Rifampin versus Nine Months Isoniazid for Latent TB in Adults' was authored by Dr. Dick Menzies, DOI: 10.1056/NEJMoa1714283.

Links to the studies:

Children: http://www.nejm.org/doi/full/10.1056/NEJMoa1714284The study 'Safety and Side Effects of Rifampin versus Isoniazid in Children' was supported by a grant from the Canadian Institutes of Health Research; the Brazilian portion of the study was supported by a grant from the Conselho Nacional de Pesquisa in Brazil. The study 'Four Months of Rifampin or Nine Months of Isoniazid for Latent Tuberculosis in Adults' was supported by a grant from the Canadian Institutes of Health Research and the Australian portion was supported by the Australian National Health and Medical Research Council.

About the Research Institute of the MUHC

The Research Institute of the McGill University Health Centre (RI-MUHC) is a world-renowned biomedical and healthcare research centre. The Institute, which is affiliated with the Faculty of Medicine of McGill University, is the research arm of the McGill University Health Centre (MUHC) - an academic health centre located in Montreal, Canada, that has a mandate to focus on complex care within its community. The RI-MUHC supports over 420 researchers and close to 1,200 research trainees devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Its research facilities offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at improving the health of individual patients across their lifespan. The RI-MUHC is supported in part by the Fonds de recherche du Québec - Santé (FRQS). http://www.rimuhc.ca.

To arrange media interviews with Dr. Menzies, please contact:

Paul Logothetis
Communications Officer
McGill University Health Centre
514-210-6376
Paul.Logothetis@muhc.mcgill.ca

McGill University Health Centre

Related Children Articles:

Preterm children have similar temperament to children who were institutionally deprived
A child's temperament is affected by the early stages of their life.
Only-children more likely to be obese than children with siblings
Families with multiple children tend to make more healthy eating decisions than families with a single child.
Children living in countryside outperform children living in metropolitan area in motor skills
Residential density is related to children's motor skills, engagement in outdoor play and organised sports. that Finnish children living in the countryside spent more time outdoors and had better motor skills than their age peers in the metropolitan area.
Hispanic and black children more likely to miss school due to eczema than white children
In a study that highlights racial disparities in the everyday impact of eczema, new research shows Hispanic and black children are more likely than white children to miss school due to the chronic skin disease.
Children, their parents, and health professionals often underestimate children's higher weight status
More than half of parents underestimated their children's classification as overweight or obese -- children themselves and health professionals also share this misperception, according to new research being presented at this year's European Congress on Obesity (ECO) in Glasgow, UK (April 28-May 1).
Children with autism are in 'in-tune' with mom's feelings like other children
New research addresses limitations of prior autism spectrum disorder (ASD) studies on facial emotion recognition by using five distinct facial emotions in unfamiliar and familiar (mom) faces to test the influence of familiarity in children with and without ASD.
First Nations children and youth experiencing more pain than non-First Nations children
First Nations children and youth are experiencing more pain than non-First Nations children, but do not access specialist or mental health services at the same rate as their non-First Nations peers, found new research published in CMAJ (Canadian Medical Association Journal).
Grandparents: Raising their children's children, they get the job done
Millions of children are being raised solely by their grandparents, with numbers continuing to climb as the opioid crisis and other factors disrupt families.
How do you assess pain in children who can't express themselves? New research identifies priorities in identifying pain in nonverbal children with medical complexity
Pain is a frequent problem for children with complex medical conditions -- but many of them are unable to communicate their pain verbally.
Under age 13, suicide rates are roughly double for black children vs. white children
A new study published in JAMA Pediatrics shows that racial disparities in suicide rates are age-related.
More Children News and Children Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

In & Out Of Love
We think of love as a mysterious, unknowable force. Something that happens to us. But what if we could control it? This hour, TED speakers on whether we can decide to fall in — and out of — love. Guests include writer Mandy Len Catron, biological anthropologist Helen Fisher, musician Dessa, One Love CEO Katie Hood, and psychologist Guy Winch.
Now Playing: Science for the People

#543 Give a Nerd a Gift
Yup, you guessed it... it's Science for the People's annual holiday episode that helps you figure out what sciency books and gifts to get that special nerd on your list. Or maybe you're looking to build up your reading list for the holiday break and a geeky Christmas sweater to wear to an upcoming party. Returning are pop-science power-readers John Dupuis and Joanne Manaster to dish on the best science books they read this past year. And Rachelle Saunders and Bethany Brookshire squee in delight over some truly delightful science-themed non-book objects for those whose bookshelves are already full. Since...
Now Playing: Radiolab

An Announcement from Radiolab