Condition

Multidrug-resistant tuberculosis without extensive drug resistance

Clinical trials and treatment information for Multidrug-resistant tuberculosis without extensive drug resistance

654K
People Affected
150
Active Trials
450K
New Cases/Year
107K
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 (BPaL) Regimen
90% Effectiveness• 85% Confidence• 55% Safety• 8 trials• 650 participants
HIGH EvidenceGood ValueDose: Bedaquiline 400mg daily for 2 weeks, then 200mg 3x/week for 22 weeks; Pretomanid 200mg daily; Linezolid 600mg daily (often reduced to 300mg daily)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
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55
DangerousModerateSafe

Time to Effect

2-4 weeks for initial response, 2-3 months for culture conversion

Duration

6 months

Response Rate

92%

Remission Rate

88%

Common Side Effects:

Peripheral neuropathy (Linezolid): 55%
Myelosuppression (Linezolid): 15%
QT prolongation (Bedaquiline): 15%
Nausea/Vomiting: 25%

Annual Cost of Care

Drug Cost

$15,000

Monitoring

$3,000

Side Effects

$2,000

Total Annual

$20,000

Cost-Effectiveness

GOOD

QALYs Gained

0.8

ICER

$75,000/QALY

Cost per Remission

$22,727

Cost per Responder

$21,739

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+90%
Response Rate
+92%
Remission Rate
+88%
Common Side Effects
Peripheral neuropathy (Linezolid)
+55%
Myelosuppression (Linezolid)
+15%
QT prolongation (Bedaquiline)
+15%

Clinical Trial Phases:

Phase 3Phase 4
2
Bedaquiline-based Regimen (longer course)
80% Effectiveness• 90% Confidence• 58% Safety• 50 trials• 10K participants
HIGH EvidenceGood ValueDose: Bedaquiline 400mg daily for 2 weeks, then 200mg 3x/week for 22 weeks, combined with other second-line drugs for full duration
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
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Chemo☢️
Alcohol🍺
Morphine💊
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58
DangerousModerateSafe

Time to Effect

2-3 months for culture conversion

Duration

18-24 months

Response Rate

82%

Remission Rate

78%

Common Side Effects:

QT prolongation (Bedaquiline): 15%
Hepatotoxicity: 8%
Nausea/Vomiting: 15%

Annual Cost of Care

Drug Cost

$15,000

Monitoring

$4,000

Side Effects

$3,000

Total Annual

$22,000

Cost-Effectiveness

GOOD

QALYs Gained

0.7

ICER

$90,000/QALY

Cost per Remission

$28,205

Cost per Responder

$26,829

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+80%
Response Rate
+82%
Remission Rate
+78%
Common Side Effects
QT prolongation (Bedaquiline)
+15%
Hepatotoxicity
+8%
Nausea/Vomiting
+15%

Clinical Trial Phases:

Phase 3Phase 4
3
Delamanid-based Regimen (longer course)
78% Effectiveness• 85% Confidence• 60% Safety• 30 trials• 5K participants
HIGH EvidenceModerate ValueDose: Delamanid 100mg twice daily for 6 months, combined with other second-line drugs for full duration
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe

Time to Effect

2-3 months for culture conversion

Duration

18-24 months

Response Rate

78%

Remission Rate

73%

Common Side Effects:

QT prolongation (Delamanid): 15%
Nausea/Vomiting: 10%
Headache: 8%

Annual Cost of Care

Drug Cost

$14,000

Monitoring

$4,000

Side Effects

$2,500

Total Annual

$20,500

Cost-Effectiveness

MODERATE

QALYs Gained

0.65

ICER

$110,000/QALY

Cost per Remission

$28,082

Cost per Responder

$26,282

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+78%
Response Rate
+78%
Remission Rate
+73%
Common Side Effects
QT prolongation (Delamanid)
+15%
Nausea/Vomiting
+10%
Headache
+8%

Clinical Trial Phases:

Phase 3Phase 4
4
Standardized Shorter MDR-TB Regimen (SSR)
75% Effectiveness• 80% Confidence• 48% Safety• 20 trials• 8K participants
MODERATE EvidenceGood ValueDose: Standard regimen including Moxifloxacin, Ethionamide, Pyrazinamide, Ethambutol, Clofazimine, and an injectable for 4-6 months
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
48
DangerousModerateSafe

Time to Effect

1-2 months for culture conversion

Duration

9-12 months

Response Rate

78%

Remission Rate

73%

Common Side Effects:

Hearing loss/vestibular toxicity (injectables): 25%
Nephrotoxicity (injectables): 12%
Gastrointestinal intolerance: 45%
QT prolongation: 20%
Hypothyroidism: 10%

Annual Cost of Care

Drug Cost

$8,000

Monitoring

$4,000

Side Effects

$3,000

Total Annual

$15,000

Cost-Effectiveness

GOOD

QALYs Gained

0.5

ICER

$60,000/QALY

Cost per Remission

$20,548

Cost per Responder

$19,231

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+75%
Response Rate
+78%
Remission Rate
+73%
Common Side Effects
Hearing loss/vestibular toxicity (injectables)
+25%
Nephrotoxicity (injectables)
+12%
Gastrointestinal intolerance
+45%

Clinical Trial Phases:

Phase 4
5
High-dose Moxifloxacin-based Regimen
72% Effectiveness• 85% Confidence• 62% Safety• 40 trials• 6K participants
MODERATE EvidenceExcellent ValueDose: Moxifloxacin 400-800mg daily, combined with other second-line drugs
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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

2-3 months for culture conversion

Duration

18-24 months

Response Rate

73%

Remission Rate

68%

Common Side Effects:

QT prolongation: 15%
Gastrointestinal upset: 15%
Tendonitis/rupture: 3%
CNS effects (dizziness, insomnia): 7%

Annual Cost of Care

Drug Cost

$5,000

Monitoring

$4,000

Side Effects

$2,500

Total Annual

$11,500

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.45

ICER

$50,000/QALY

Cost per Remission

$16,912

Cost per Responder

$15,753

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+72%
Response Rate
+73%
Remission Rate
+68%
Common Side Effects
QT prolongation
+15%
Gastrointestinal upset
+15%
Tendonitis/rupture
+3%

Clinical Trial Phases:

Phase 3Phase 4
6
Conventional Longer MDR-TB Regimen (Injectable-containing)
60% Effectiveness• 95% Confidence• 40% Safety• 100 trials• 20K participants
HIGH EvidencePoor ValueDose: Highly variable, individualized; includes an injectable drug for 6-8 months, and at least 4-5 second-line oral drugs
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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

3-4 months for culture conversion

Duration

18-24 months

Response Rate

62%

Remission Rate

58%

Common Side Effects:

Hearing loss/vestibular toxicity (injectables): 40%
Nephrotoxicity (injectables): 25%
Gastrointestinal intolerance: 60%
Psychiatric disturbances (Cycloserine): 15%
Hypothyroidism (Ethionamide, PAS): 15%

Annual Cost of Care

Drug Cost

$4,000

Monitoring

$6,000

Side Effects

$5,000

Total Annual

$15,000

Cost-Effectiveness

POOR

QALYs Gained

0.3

ICER

$150,000/QALY

Cost per Remission

$25,862

Cost per Responder

$24,194

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+60%
Response Rate
+62%
Remission Rate
+58%
Common Side Effects
Hearing loss/vestibular toxicity (injectables)
+40%
Nephrotoxicity (injectables)
+25%
Gastrointestinal intolerance
+60%

Clinical Trial Phases:

Phase 4