Clinical and epidemiologic research in Tuberculosis

Dr. Dick Menzies
Professor of Medicine, and of Epidemiology & Biostatistics, McGill University
Photo credited to Owen Egan (McGill)

Between 2002 and 2018 with CIHR funding, Dr. Menzies and his team completed Phases 1, 2 and 3 clinical trials in adults and children to compare 4 months Rifampin (4R) with 9 Months Isoniazid (9H) for treatment of latent TB infection (TB prevention). These trials demonstrated that 4R was better completed, with fewer adverse events (safer), less health system costs (cheaper), yet as effective as 9H in adults and children of all ages. As a result of these trials, 4R is now recommended as a treatment for TB prevention by the World Health Organization, the Centres for Disease Control in the United States, and is now considered the standard of care in Canada. A recent trial, completed with CIHR support, evaluated new strategies to scale up TB preventive therapy among close contacts of persons with active TB, and ongoing CIHR funded trials are evaluating optimal management strategies form Latent TB investigation, as well as a novel 2-month regimen of high dose Rifampin for TB prevention.

“As a result of CIHR funded research, 4R is now the standard of care for TB prevention in the US and Canada, replacing 9H. Current and recent trials will provide evidence for better coverage of this treatment - to ensure it is offered and taken by many more people who are at risk of developing TB. This is a key element of TB elimination - in Canada, and globally.”

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