Condition

Extensively drug-resistant tuberculosis

Clinical trials and treatment information for Extensively drug-resistant tuberculosis

28K
People Affected
5
Active Trials
25K
New Cases/Year
7,946
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
BPaL regimen (Bedaquiline + Pretomanid + Linezolid)
88% Effectiveness• 90% Confidence• 40% Safety• 1 trials• 1K participants
HIGH EvidenceExcellent ValueDose: Bedaquiline: 400mg daily for 2 weeks, then 200mg 3x/week for 22 weeks; Pretomanid: 200mg daily for 26 weeks; Linezolid: 600mg daily for 26 weeks (may be reduced to 300mg daily)
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Comparative Safety Scale(Higher is safer)

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40
DangerousModerateSafe

Time to Effect

3-6 months

Duration

6-9 months

Response Rate

85%

Remission Rate

85%

Common Side Effects:

Peripheral neuropathy: 60%
Myelosuppression: 15%
QT prolongation: 12%
Hepatotoxicity: 8%
Nausea/Vomiting/Diarrhea: 30%

Annual Cost of Care

Drug Cost

$15,000

Monitoring

$3,500

Side Effects

$2,000

Total Annual

$20,500

Cost-Effectiveness

EXCELLENT

QALYs Gained

2

ICER

$10,000/QALY

Cost per Remission

$24,118

Cost per Responder

$24,118

Treatment Outcomes
Primary Outcomes
Treatment Success Rate (Favorable Outcome)35% (historical for XDR-TB)
+142.86% (+50 percentage points)
Sputum Culture Conversion Rate at Month 630% (historical for XDR-TB)
+183.33% (+55 percentage points)
Total Treatment Duration18 months (conventional XDR-TB regimen)
-66.67% (-12 months)
Rate of Treatment Discontinuation due to Adverse Events30% (conventional XDR-TB regimens)
-50% (-15 percentage points)
Secondary Benefits
WHOQOL-BREF Physical Health Domain Score30/100 (low score, indicating poor physical QoL)
+100% (+30 points)
Mean Days of Hospitalization90 days (for initial management of XDR-TB)
-66.67% (-60 days)
Proportion of Patients Returning to Work/School20% (for conventional, long XDR-TB treatment)
+200% (+40 percentage points)
Common Side Effects
Peripheral neuropathy
+60%
Myelosuppression
+15%
QT prolongation
+12%

Clinical Trial Phases:

Phase 3Phase 4
2
Bedaquiline (as part of longer regimens)
80% Effectiveness• 90% Confidence• 50% Safety• 25 trials• 4K participants
HIGH EvidenceExcellent ValueDose: 400mg daily for 2 weeks, then 200mg three times a week for 22 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
50
DangerousModerateSafe

Time to Effect

3-6 months

Duration

6 months (within 18-24 month regimen)

Response Rate

75%

Remission Rate

75%

Common Side Effects:

QT prolongation: 15%
Nausea: 18%
Arthralgia: 12%
Hepatotoxicity: 7%

Annual Cost of Care

Drug Cost

$4,000

Monitoring

$2,000

Side Effects

$1,000

Total Annual

$7,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.2

ICER

$20,000/QALY

Cost per Remission

$9,333

Cost per Responder

$9,333

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+80%
Response Rate
+75%
Remission Rate
+75%
Common Side Effects
QT prolongation
+15%
Nausea
+18%
Arthralgia
+12%

Clinical Trial Phases:

Phase 3Phase 4
3
Delamanid (as part of longer regimens)
78% Effectiveness• 85% Confidence• 50% Safety• 15 trials• 2.5K participants
HIGH EvidenceExcellent ValueDose: 100mg twice daily for 24 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
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50
DangerousModerateSafe

Time to Effect

3-6 months

Duration

6 months (within 18-24 month regimen)

Response Rate

75%

Remission Rate

75%

Common Side Effects:

QT prolongation: 15%
Nausea/Vomiting: 20%
Headache: 12%

Annual Cost of Care

Drug Cost

$5,000

Monitoring

$2,000

Side Effects

$1,000

Total Annual

$8,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.1

ICER

$25,000/QALY

Cost per Remission

$10,667

Cost per Responder

$10,667

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+78%
Response Rate
+75%
Remission Rate
+75%
Common Side Effects
QT prolongation
+15%
Nausea/Vomiting
+20%
Headache
+12%

Clinical Trial Phases:

Phase 3Phase 4
4
Linezolid (as part of regimens)
75% Effectiveness• 80% Confidence• 35% Safety• 40 trials• 5K participants
MODERATE EvidenceGood ValueDose: 300-600mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
35
DangerousModerateSafe

Time to Effect

3-6 months

Duration

6-24 months

Response Rate

70%

Remission Rate

70%

Common Side Effects:

Peripheral neuropathy: 50%
Myelosuppression (anemia, thrombocytopenia): 15%
Optic neuritis: 7%
Gastrointestinal intolerance: 15%

Annual Cost of Care

Drug Cost

$2,000

Monitoring

$3,000

Side Effects

$4,500

Total Annual

$9,500

Cost-Effectiveness

GOOD

QALYs Gained

0.8

ICER

$35,000/QALY

Cost per Remission

$13,571

Cost per Responder

$13,571

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+75%
Response Rate
+70%
Remission Rate
+70%
Common Side Effects
Peripheral neuropathy
+50%
Myelosuppression (anemia, thrombocytopenia)
+15%
Optic neuritis
+7%

Clinical Trial Phases:

Phase 3Phase 4
5
Clofazimine (as part of regimens)
65% Effectiveness• 75% Confidence• 60% Safety• 15 trials• 1K participants
LOW EvidenceGood ValueDose: 100-200mg daily
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Comparative Safety Scale(Higher is safer)

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Meth💀
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Morphine💊
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60
DangerousModerateSafe

Time to Effect

3-6 months

Duration

6-18 months

Response Rate

65%

Remission Rate

65%

Common Side Effects:

Skin discoloration (reddish-brown to black): 90%
Gastrointestinal intolerance: 45%
Ichthyosis/dry skin: 15%

Annual Cost of Care

Drug Cost

$400

Monitoring

$750

Side Effects

$300

Total Annual

$1,450

Cost-Effectiveness

GOOD

QALYs Gained

0.6

ICER

$40,000/QALY

Cost per Remission

$2,231

Cost per Responder

$2,231

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+65%
Response Rate
+65%
Remission Rate
+65%
Common Side Effects
Skin discoloration (reddish-brown to black)
+90%
Gastrointestinal intolerance
+45%
Ichthyosis/dry skin
+15%

Clinical Trial Phases:

Phase 4
6
Ethionamide / Prothionamide (as part of regimens)
60% Effectiveness• 70% Confidence• 45% Safety• 20 trials• 1.5K participants
LOW EvidenceGood ValueDose: 250-1000mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
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45
DangerousModerateSafe

Time to Effect

3-6 months

Duration

18-24 months

Response Rate

60%

Remission Rate

60%

Common Side Effects:

Gastrointestinal intolerance: 60%
Hepatotoxicity: 15%
Psychiatric disturbances (depression, psychosis): 12%
Peripheral neuropathy: 15%
Hypothyroidism: 7%

Annual Cost of Care

Drug Cost

$250

Monitoring

$1,500

Side Effects

$1,500

Total Annual

$3,250

Cost-Effectiveness

GOOD

QALYs Gained

0.5

ICER

$50,000/QALY

Cost per Remission

$5,417

Cost per Responder

$5,417

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+60%
Response Rate
+60%
Remission Rate
+60%
Common Side Effects
Gastrointestinal intolerance
+60%
Hepatotoxicity
+15%
Psychiatric disturbances (depression, psychosis)
+12%

Clinical Trial Phases:

Phase 4
7
Cycloserine / Terizidone (as part of regimens)
58% Effectiveness• 70% Confidence• 40% Safety• 20 trials• 1.5K participants
LOW EvidenceModerate ValueDose: 250-1000mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
40
DangerousModerateSafe

Time to Effect

3-6 months

Duration

18-24 months

Response Rate

55%

Remission Rate

55%

Common Side Effects:

Psychiatric disturbances (anxiety, depression, psychosis): 35%
Seizures: 7%
Peripheral neuropathy: 12%
Headache/Dizziness: 20%

Annual Cost of Care

Drug Cost

$200

Monitoring

$2,000

Side Effects

$3,000

Total Annual

$5,200

Cost-Effectiveness

MODERATE

QALYs Gained

0.4

ICER

$60,000/QALY

Cost per Remission

$9,455

Cost per Responder

$9,455

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+58%
Response Rate
+55%
Remission Rate
+55%
Common Side Effects
Psychiatric disturbances (anxiety, depression, psychosis)
+35%
Seizures
+7%
Peripheral neuropathy
+12%

Clinical Trial Phases:

Phase 4