Update of the WHO guidance on the treatment of drug susceptible TB

Drug susceptible TB affects approximately 7 million people annually. It is currently treated with four first line TB medicines for a period of six months. Approximately 85% of patients who take the six-month regimen will have a successful treatment outcome. Ensuring access to effective treatment is a key component of the End TB Strategy, which includes a priority indicator that 90% or more of patients should have a successful treatment outcome.

Despite its effectiveness, the current treatment regimen of six months remains too long for many patients. In recent years, research efforts have been directed towards finding safe and effective shorter regimens. New evidence from a randomized controlled trial on a 4-month treatment regimen containing a fluoroquinolone and high dose rifapentine has recently become available to WHO. This will be the evidence that will be reviewed and considered by the GDG.

WHO last updated its guidance on the treatment of drug susceptible TB in 2017. At this time WHO issued a recommendation against the use of shorter fluoroquinolone containing regimens as the evidence did not support that these regimens were more effective than the six-month regimen. However, it is now time to review the evidence on shorter regimens again, to provide users worldwide with the most up to date evidence-informed guidance on how to treat drug susceptible TB.

The GDG meeting will be held online in late April 2021, in accordance with WHO requirements for the development of evidence-informed policy guidance. The updated recommendations will be released in 2021, as part of the treatment module of the WHO consolidated guidelines on tuberculosis. More details of the process, inclusive of brief biographies of the experts invited to serve in the current GDG, are available here.

Source: WHO