New way found to improve efficacy of TB treatment

By Bhavya Khullar

New Delhi: Indian scientists have found a new way to improve efficacy of existing TB treatment in patients reporting relapse of the disease after treatment.

The new add-on therapy consists of injecting ‘heat-killed’ bacteria of a species called Mycobacterium indicus pranii (MIP) into patients along with standard TB drugs. The approach has been tested in category II pulmonary TB patients, and found effective in clearing TB bacteria faster. MIP had earlier shown immunotherapeutic effects in multibacillary leprosy patients.

Standard TB treatment consists of antibiotics, but in some cases the infection reappears due to failed treatment or lack of compliance. Such cases are called category II pulmonary TB patients, and they are more likely to develop multi drug resistance.

A group of patients were given the adjuvant therapy along with DOTS (Directly Observed Treatment, Short course), while the other received only DOTS and a placebo. All the 890 patients were followed up for two years. In four weeks, 67% patients with the adjuvant therapy converted to sputum culture negative compared to 57% in the placebo group. By the end of the treatment, adjuvant therapy helped 94.2% patients recover compared to 89% in the placebo group.

“This demonstrates superiority of MIP (adjuvant) in inducing early culture negativity and improving the cure rate of Category II Pulmonary TB patients with parameters that would include them in ‘difficult-to-treat’ category,” said Dr. Rajni Rani of Institute of Genomics and Integrative Biology in New Delhi, who led the research team.

“Our study has implications in eradicating TB in the longer run”, she added. “The study now has to be done on a larger group of category II patients and in multi-drug resistant patients to evaluate its efficacy.” The study results have appeared in journal Scientific Reports.

The team included Surendra K Sharma, Kiran Katoch, Rohit Sarin, Raman Balambal, Nirmal Kumar Jain, Naresh Patel, Kolluri J R Murthy, Neeta Singla, P K Saha, Ashwani Khanna, Urvashi Singh, Sanjiv Kumar, A Sengupta, J N Banavaliker, D S Chauhan, Shailendra Sachan, Mohammad Wasim, Sanjay Tripathi, Nilesh Dutt, Nitin Jain, Nalin Joshi, Sita Ram Raju Penmesta, Sumanlatha Gaddam, Sanjay Gupta, Bakulesh Khamar, Bindu Dey, Dipendra K Mitra, Sunil K Arora, Sangeeta Bhaskar, and Rajni Rani.

The study was jointly done by the All India Institute of Medical Sciences (AIIMS), New Delhi; National JALMA Institute of Leprosy and Other Mycobacterial Diseases, Agra; National Institute of Tuberculosis and Respiratory Diseases, New Delhi; National Institute of Research in Tuberculosis, Chennai; SMS Medical College in Jaipur, Rajasthan; NHL Municipal Medical College in Ahmadabad; Mahavir Hospital and Research Centre, Hyderabad; RBTB Hospital, New Delhi; Post Graduate Institute of Medical Education and Research, Chandigarh; Chest Clinic and Hospital, New Delhi; and National Institute of Immunology, New Delhi. (India Science Wire)