Condition

HIV/AIDS - Extensively drug-resistant Tuberculosis

Clinical trials and treatment information for HIV/AIDS - Extensively drug-resistant Tuberculosis

15K
People Affected
5
Active Trials
5,000
New Cases/Year
840
Deaths/Year

Treatment Rankings

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

1
Bedaquiline + Pretomanid + Linezolid + Moxifloxacin (BPaLM Regimen)
89% Effectiveness• 90% Confidence• 36% Safety• 15 trials• 1.5K participants
HIGH EvidenceExcellent ValueDose: Bedaquiline: 400mg daily (2 weeks), then 200mg 3x/week (22 weeks); Pretomanid: 200mg daily; Linezolid: 600mg daily (often reduced to 300mg); Moxifloxacin: 400mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
36
DangerousModerateSafe

Time to Effect

2-4 weeks (sputum conversion), 1-2 months (clinical improvement)

Duration

6-9 months

Response Rate

89%

Remission Rate

89%

Number Needed to Treat (NNT)

2

Number Needed to Harm (NNH)

7

Common Side Effects:

Peripheral neuropathy: 60%
Myelosuppression (anemia, thrombocytopenia): 25%
Hepatotoxicity: 20%
QT prolongation: 20%
Optic neuropathy: 7%
Gastrointestinal disturbances: 15%
Tendonitis/rupture: 5%

Annual Cost of Care

Drug Cost

$41,000

Monitoring

$4,000

Side Effects

$6,000

Total Annual

$51,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

8

ICER

$6,375/QALY

Cost per Remission

$57,303

Cost per Responder

$57,303

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+89%
Response Rate
+89%
Remission Rate
+89%
Common Side Effects
Peripheral neuropathy
+60%
Myelosuppression (anemia, thrombocytopenia)
+25%
Hepatotoxicity
+20%

Clinical Trial Phases:

Phase 3Phase 4
2
Bedaquiline + Pretomanid + Linezolid (BPaL Regimen)
88% Effectiveness• 90% Confidence• 38% Safety• 12 trials• 2K participants
HIGH EvidenceExcellent ValueDose: Bedaquiline: 400mg daily (2 weeks), then 200mg 3x/week (22 weeks); Pretomanid: 200mg daily; Linezolid: 600mg daily (often reduced to 300mg)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
38
DangerousModerateSafe

Time to Effect

2-4 weeks (sputum conversion), 1-2 months (clinical improvement)

Duration

6-9 months

Response Rate

88%

Remission Rate

88%

Number Needed to Treat (NNT)

2

Number Needed to Harm (NNH)

7

Common Side Effects:

Peripheral neuropathy: 60%
Myelosuppression (anemia, thrombocytopenia): 25%
Hepatotoxicity: 20%
QT prolongation: 15%
Optic neuropathy: 5%
Gastrointestinal disturbances: 15%

Annual Cost of Care

Drug Cost

$40,000

Monitoring

$4,000

Side Effects

$5,000

Total Annual

$49,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

8

ICER

$6,125/QALY

Cost per Remission

$55,682

Cost per Responder

$55,682

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+88%
Response Rate
+88%
Remission Rate
+88%
Common Side Effects
Peripheral neuropathy
+60%
Myelosuppression (anemia, thrombocytopenia)
+25%
Hepatotoxicity
+20%

Clinical Trial Phases:

Phase 3Phase 4
3
Linezolid (as component of XDR-TB regimen)
80% Effectiveness• 90% Confidence• 34% Safety• 50 trials• 10K participants
HIGH EvidenceDose: 600mg daily (often reduced to 300mg daily)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
34
DangerousModerateSafe

Time to Effect

Contributes to sputum conversion within weeks (as part of regimen)

Duration

Typically 6-9 months (as part of regimen)

Response Rate

%

Remission Rate

%

Number Needed to Harm (NNH)

7

Common Side Effects:

Peripheral neuropathy: 60%
Myelosuppression (anemia, thrombocytopenia): 25%
Optic neuropathy: 7%
Lactic acidosis: 5%
Gastrointestinal disturbances: 15%

Annual Cost of Care

Drug Cost

$3,000

Monitoring

$2,000

Side Effects

$3,000

Total Annual

$8,000

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+80%
Common Side Effects
Peripheral neuropathy
+60%
Myelosuppression (anemia, thrombocytopenia)
+25%
Optic neuropathy
+7%

Clinical Trial Phases:

Phase 4
4
Delamanid + Bedaquiline + Optimized Background Regimen (OBR)
75% Effectiveness• 85% Confidence• 32% Safety• 15 trials• 1.5K participants
MODERATE EvidenceExcellent ValueDose: Delamanid: 100mg twice daily (6 months); Bedaquiline: 400mg daily (2 weeks), then 200mg 3x/week (22 weeks); OBR drugs (e.g., Clofazimine 100mg daily, Cycloserine 250-500mg twice daily)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
32
DangerousModerateSafe

Time to Effect

2-3 months (sputum conversion), 3-6 months (clinical improvement)

Duration

18-24 months

Response Rate

75%

Remission Rate

75%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

8

Common Side Effects:

QT prolongation: 20%
Hepatotoxicity: 15%
Skin discoloration (from Clofazimine in OBR): 90%
Gastrointestinal issues: 30%
Neuropsychiatric effects (from Cycloserine in OBR): 25%
Peripheral neuropathy: 10%

Annual Cost of Care

Drug Cost

$53,000

Monitoring

$7,000

Side Effects

$8,000

Total Annual

$68,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

6

ICER

$11,333/QALY

Cost per Remission

$90,667

Cost per Responder

$90,667

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+75%
Response Rate
+75%
Remission Rate
+75%
Common Side Effects
QT prolongation
+20%
Hepatotoxicity
+15%
Skin discoloration (from Clofazimine in OBR)
+90%

Clinical Trial Phases:

Phase 3Phase 4
5
Clofazimine (as component of XDR-TB regimen)
65% Effectiveness• 85% Confidence• 62% Safety• 100 trials• 20K participants
MODERATE EvidenceDose: 100mg daily or 300mg three times a week
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
62
DangerousModerateSafe

Time to Effect

Contributes to regimen effect over months

Duration

Typically 18-24 months (as part of regimen)

Response Rate

%

Remission Rate

%

Number Needed to Harm (NNH)

15

Common Side Effects:

Skin discoloration (reddish-brown to black): 90%
Ichthyosis/dry skin: 50%
Gastrointestinal issues (abdominal pain, nausea, diarrhea): 30%
QT prolongation: 3%

Annual Cost of Care

Drug Cost

$800

Monitoring

$500

Side Effects

$1,000

Total Annual

$2,300

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+65%
Common Side Effects
Skin discoloration (reddish-brown to black)
+90%
Ichthyosis/dry skin
+50%
Gastrointestinal issues (abdominal pain, nausea, diarrhea)
+30%

Clinical Trial Phases:

Phase 4