Dr. Chen-Yuan Chiang joins global third-phase clinical trial for MDR-TB

Source: College of Medicine

Published on 2019-12-11

College of Medicine Associate Professor Chen-Yuan Chiang’s team has spent nearly ten years completing a third-phase clinical trial for multidrug-resistant tuberculosis proving that the efficacy of 9-11 month short-course treatment is no worse than the 18-24 month long-course treatment advocated by the World Health Organization. 

Results appeared in the New England Journal of Medicine (NEJM) in March 2019.

Associate Professor Chen-Yuan Chiang

Associate Professor Chen-Yuan Chiang has long been internationally known for his work on TB prevention and treatment. He is a consultant for WHO’s multidrug-resistant TB committee.

The current WHO treatment for tuberculosis can last 18-24 months with patients taking medication 1-2 times a day without any break in the treatment. Since four to seven drugs need to be taken and each drug has side effects, patients may be reluctant to complete their treatment, leading to a cure rate of around 50%. In comparison, the short-course treatment utilized by Prof. Chiang’s group is a 9-11 month course of similar drugs in different combinations. The short course’s lower cost and reduced side effects also improve adherence.

The research utilized Clofazimine, which was previously used to treat leprosy, in combination with other drugs to treat multidrug-resistant tuberculosis. After ten years of clinical trials involving several groups in different countries, it has been shown that the treatment course can be reduced to 9-11 months, as the 78% efficacy is no worse than results from the traditional 18-24 month long-course treatment, providing significant and obvious benefits.

 Did you know?

There is not much emphasis on TB prevention and treatment in Taiwan, so patients may feel little social pressure to complete their treatment. In May 2007 Taiwan’s Centers for Disease Control set up five medical teams around Taiwan to treat over 400 multidrug-resistant TB patients every year, and after close to a decade of hard work, the number has dropped to around 200, with the failure rate dropping to 3%, showing a high degree of patient willingness to receive treatment.

Dr. Chiang believes the short-course treatment’s similar efficacy, lower costs and milder side effects will provide patients with a new choice, and that it will gradually become the mainstay in treating multidrug-resistant tuberculosis.

Associate Professor Chen-Yuan Chiang’s New England Journal of Medicine article.

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