On October 26th, 2016 The Lancet Infectious Diseases published the most recent findings from the multi-arm, multi stage tuberculosis (MAMS-TB) trial of the PanACEA consortium. The MAMS-TB trial investigated four new potential regimens for the treatment of tuberculosis.
Trial results show that the highest rifampicin dose tested (35 mg/kg) is safe and reduces the time to culture conversion in liquid media compared to the standard dose (10 mg/kg). The 35 mg/kg dose has promise to progress to phase 3 as an important component of future, shorter regimens to be assessed for improvement of relapse rates.
The data bring into question the utility of regimens with relatively low increases in the dose of rifampicin, suggesting that they are not likely to provide significant benefit or treatment shortening. In this light, the results suggest that higher doses than 35 mg/kg should also be evaluated for safety and efficacy.
Finally, this is the first time that a multi-arm adaptive trial design was successfully implemented in a multi-centre study in a high tuberculosis burden setting. This approach might accelerate tuberculosis regimen development at a reduced cost.