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Publication Detail
Failure or relapse predictors for the STREAM Stage 1 short regimen for RR-TB
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Kokebu DM, Ahmed S, Moodliar R, Chiang C-Y, Torrea G, Van Deun A, Goodall RL, Rusen ID, Meredith SK, Nunn AJ
  • Publisher:
    International Union Against Tuberculosis and Lung Disease
  • Publication date:
  • Pagination:
    753, 759
  • Journal:
    International Journal of Tuberculosis and Lung Disease
  • Volume:
  • Issue:
  • Medium:
  • Status:
  • Country:
  • Print ISSN:
  • Language:
BACKGROUND: STREAM (Standardised Treatment Regimens of Anti-tuberculosis drugs for Multidrug-Resistant Tuberculosis) Stage 1 demonstrated non-inferior efficacy of a short regimen for rifampicin-resistant TB (RR-TB) compared to a long regimen as recommended by the WHO. The present paper analyses factors associated with a definite or probable failure or relapse (FoR) event in participants receiving the Short regimen.METHODS: This analysis is restricted to 253 participants allocated to the Short regimen and is based on the protocol-defined modified intention to treat (mITT) population. Multivariable Cox regression models were built using backwards elimination with an exit probability of P = 0.157, equivalent to the Akaike Information Criterion, to identify factors independently associated with a definite or probable FoR event.RESULTS: Four baseline factors were identified as being significantly associated with the risk of definite or probable FoR (male sex, a heavily positive baseline smear grade, HIV co-infection and the presence of costophrenic obliteration). There was evidence of association of culture positivity at Week 8 and FoR in a second model and Week 16 smear positivity, presence of diabetes and of smoking in a third model.CONCLUSION: The factors associated with FoR outcomes identified in this analysis should be considered when determining the optimal shortened treatment regimen.
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