Treatment of tuberculous meningitis: Overdue for concerted action

Article Immunology

Cognitive Impairment in Tuberculous Meningitis

Angharad G. Davis et al.

Summary: This study systematically assessed the frequency and nature of cognitive impairment in adult tuberculous meningitis patients and found that it has an impact on functioning and medication adherence.

CLINICAL INFECTIOUS DISEASES (2023)

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Article Immunology

A Phase 2A Trial of the Safety and Tolerability of Increased Dose Rifampicin and Adjunctive Linezolid, With or Without Aspirin, for Human Immunodeficiency Virus-Associated Tuberculous Meningitis: The LASER-TBM Trial

Angharad G. Davis et al.

Summary: In this study, it was demonstrated that high-dose rifampicin and adjunctive linezolid is safe in adult HIV-associated tuberculous meningitis patients. Larger studies are needed to evaluate the potential toxicity of high-dose aspirin and its benefits on morbidity and mortality.

CLINICAL INFECTIOUS DISEASES (2023)

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Article

Establishing COVID-19 trials at scale and pace: Experience from the RECOVERY trial

Leon Peto et al.

Advances in Biological Regulation (2022)

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Article Medicine, General & Internal

Bedaquiline-Pretomanid-Linezolid Regimens for Drug-Resistant Tuberculosis

Francesca Conradie et al.

Summary: The study enrolled 181 participants with 84% to 93% achieving favorable outcomes across all four bedaquiline-pretomanid-linezolid treatment groups, with the group receiving 600 mg of linezolid daily for 26 weeks reporting fewer adverse events.

NEW ENGLAND JOURNAL OF MEDICINE (2022)

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Article Immunology

High-Dose Oral and Intravenous Rifampicin for the Treatment of Tuberculous Meningitis in Predominantly Human Immunodeficiency Virus (HIV)-Positive Ugandan Adults: A Phase II Open-Label Randomized Controlled Trial

Fiona Cresswell et al.

Summary: The study showed that high-dose rifampicin can increase serum and cerebrospinal fluid concentrations in tuberculous meningitis patients without excess toxicity. Current international guidelines result in sub-therapeutic CSF rifampicin concentration for Ugandan TBM patients.

CLINICAL INFECTIOUS DISEASES (2021)

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Article Microbiology

Plasma Pharmacokinetics of High-Dose Oral versus Intravenous Rifampicin in Patients with Tuberculous Meningitis: a Randomized Controlled Trial

Sean Wasserman et al.

Summary: The plasma rifampicin AUC(0-24) was higher after an oral 35-mg/kg dose than with intravenous administration at a 20-mg/kg dose over the first few days of tuberculosis (TB) treatment. The findings support oral rifampicin dosing in future tuberculous meningitis trials.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2021)

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Article Medicine, General & Internal

Four-Month Rifapentine Regimens with or without Moxifloxacin for Tuberculosis

S. E. Dorman et al.

Summary: The study found that a 4-month rifapentine-based regimen containing moxifloxacin was noninferior to the standard 6-month regimen in the treatment of tuberculosis, supporting the noninferiority hypothesis. This regimen was effective in both the microbiologically eligible population and the assessable population.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Article Immunology

Improving host-directed therapy for tuberculous meningitis by linking clinical and multi-omics data

Reinout van Crevel

Summary: There is a clear need to improve host-directed therapy for tuberculous meningitis (TBM), as the current therapy options are limited. The ULTIMATE project aims to address unanswered questions about tryptophan metabolism during TBM and identify novel therapeutic targets for TBM patients. Through integrating data from large patient studies and clinical trials, ULTIMATE seeks to determine which TBM patients benefit from corticosteroids and explore the potential of targeting the tryptophan pathway for treatment.

TUBERCULOSIS (2021)

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Article Immunology