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TBnet News November 2023



Today, Thursday 30 November, 16:00 CET: TBnet webinar on nontuberculous mycobacteria


Nontuberculous mycobacterial infections in bronchiectasis patients – a microbiologist’s and a clinician’s point of view.

 

Relaunch of NTMnet


Exciting news: NTMnet, an international network to promote clinically oriented research in the field of nontuberculous mycobacterial diseases, is being relaunched!

Here is the message from the new NTMnet Steering Committee:

Over the past years NTMnet has been a wonderful platform to promote international collaboration in the field of NTM by sharing experience and developing ideas for research, all thanks to the amazing work of Dirk Wagner and Jakko van Ingen, who have chaired this network over the years. In September 2023 we took over this huge task with lots of enthusiasm. Our aim is to revive NTMnet community and to spark old and new collaborations. We would like to reunite all NTM afficionados in a face-to-face meeting at ECCMID 2024. So, watch this space for more information. There is loads of work to be done, not the least to renew our website and update our membership list. We kindly ask you to bear with us while we’re working on this. Let this already be a warm appeal to sign up to this group. For now, you can get in touch with us through TBnet admin liga.r@tbnet.eu.

Andreas Arnholdt Pedersen, Victor Næstholt Dahl, Nils Wetzstein & Natalie Lorent, NTMnet Steering Committee


To meet the new NTMnet Steering Committee, tune in for today’s NTMnet/ESGMYC webinar!

 

CALL FOR PARTICIPATION: Study on Management of XDR-TB in Europe

TBnet/ESGMYC STUDY Management of XDR-TB in Europe


All TBnet members are invited to participate in an TBnet/ESGMYC study focused on the management of extensively drug-resistant tuberculosis (XDR-TB) in Europe. The study aims to describe the clinical management of XDR-TB according to the revised 2021 definitions and retrospectively evaluate treatment outcomes.


To date, only rare cases of XDR-TB based on the 2021 definitions have been reported worldwide, likely due to limited drug susceptibility testing (DST) capacity for bedaquiline and linezolid. However, resistance to new and re-purposed drugs, such as bedaquiline and linezolid, is increasing globally. While the 2022 WHO guidelines introduced a 6-month regimen for MDR/RR-TB, there are currently no alternatives available to the long and individualized treatment for XDR-TB. Outcomes of XDR-TB patients remain undescribed, but evidence suggests worse outcomes for patients treated without fluoroquinolones and bedaquiline/linezolid. This study aims to evaluate the treatment approach and outcomes of XDR-TB patients in the WHO Europe region.


This will be an observational, retrospective cohort study, and we invite any center in the WHO Europe region that has treated at least one XDR-TB patient between January 2017 and December 2023 to participate. Ethical clearance was obtained so far from the Ethics Committee of the Bligny Hospital (Briis-sous-Forges, France). Data collection will be on an MS Excel-based CRF.


If the project will lead to a peer-reviewed publication or other communications, authorship will include all active contributors of the project.


Your participation in this study would greatly contribute to our understanding of XDR-TB management in Europe. We will be very grateful if you consider your participation. For any questions, please contact xdrtb.europe@gmail.com.


Project PIs: Gunar Günther, Lorenzo Guglielmetti, Yousra Kherabi

 

A new dawn in the fight against Tuberculosis: UNITE4TB announces start of clinical trials


This month, the UNITE4TB Consortium announced the start of its phase 2B/C clinical trial program. The announcement is a major milestone for the project and the TB community as a whole, helping to advance TB science and enhance the efficiency with which new treatments are delivered.


UNITE4TB’s innovative Phase 2B/C trials will test 14 combinations of nine existing drugs, as well as two newly developed candidates (GSK656 and BTZ-043). The ultimate aim is to create regimens that can further improve multidrug-resistant treatment, and also be effective for drug-sensitive TB.


Reflecting on this latest milestone, Prof. Martin Boeree, UNITE4TB project coordinator from Radboudumc said: “Today’s announcement marks an exciting moment for TB research. The world needs new drugs for TB but also new ways to run clinical studies. Our public-private partnership sets a new standard in this regard. If successful, our work will deliver a new treatment regimen of shorter duration that can be used to fight all types of tuberculosis.”



For more updates, follow UNITE4TB on LinkedIn, X and YouTube

 

European Advanced Course on Clinical Tuberculosis in Athens, Greece


The European Advanced Course in Clinical Tuberculosis (EACCTB) is an annual course designed to update attendees in recent advances that affect clinical practice. It is a joint venture of TBnet with the KNCV, the Karolinska Institute and FILHA, who contribute to the course faculty. The course is targeted at clinicians and allied professionals interested in TB.

The facilitators of the EACCTB course

Courses have included speakers from ECDC, WHO, FIND and other internationally recognized institutions. The speakers’ remit is to provide a deep and critical understanding of issues relevant to contemporary TB management, to provoke discussion and to apply the latest TB science to clinical practice. Participants are invited to forward a case in advance for the “TB Ward on stage” for clinical advice and review by all attendees. The course begins with lunch, has a full second day and then a morning session ending with lunch on the third day.


10th EACCTB in Athens

During the 10th EACCTB in Athens, Greece there was a particular aim to support the Hellenic Thoracic Society and clinicians in south-eastern Europe regarding TB in migrants to the European Union. The course began with epidemiology, the perspective from a person who has had TB, stigma reduction and screening for TB. The second day began with a quiz to revise knowledge from the previous day. Then came recent advances in TB diagnosis (PCR tests, the Cepheid 3-gene test and whole genome sequencing), the particular problems of paediatric TB, changes in TB treatment (shorter course treatment, isoniazid monoresistance and MDR-TB with an evaluation of recent clinical trials tempered by an understanding of adverse events and how to monitor progress) followed by TB surgery and post-tuberculosis lung disease. The ward round discussed the process of TB diagnosis when not expected and TB meningitis (CSF drug levels, including those used in MDR-TB, and prognostic features). The third day began with a quiz and then entered the world of difficult clinical problems: the treatment of NTMs, when to apply therapeutic drug monitoring, HIV co-infection, TB in pregnancy, treatment in renal and liver failure and extra-pulmonary TB, followed by a review of the past year’s advances.


The highlights were:

  • The experience of a person who had a delayed diagnosis of tuberculosis and the effect of the disease on her life.

  • The tools freely available from KNCV regarding stigma reduction and peer learning modules in the Allies Approach.

  • Almost all (>95%) child deaths from TB did not receive any TB treatment.

  • NTM relapses are common due to ineffective drug regimens, the high MICs of NTMs and the current trials looking to replace rifampicin, where an effective dose would require >50 mg/kg to treat MAC.

  • The discussions during and around the presentations.

  • The clinical reviews to address the difficulties of managing TB disease.

  • But all presentations gave new knowledge and could have been highlighted!


We thank Katerina Manika, Harry Charalampos, Lina Davies Forsman and Judith Bruchfeld for leading on the organization of this meeting.

 

Latvian WHO CC for Research and Training in Management of MDR-TB announces training course for TB clinicians


WHO CC Latvia for Research and Training in Management of MDR-TB of TB and Lung Diseases Center, Riga East University Hospital announces a clinical training course for TB professionals, that will take place from 24 to 31 January 2024 in Riga, Latvia. This 7-day course combines practical implementation of the latest DR-TB guidelines, recommendations and research on clinical and programmatic management of DR-TB with intensive fieldwork - study visits, group discussions and interactive presentations by participants.

The course will be conducted January 24-31, 2024 (7 working days, including Saturday, 27 January) and the working language for this course is English.

Course details and registration are available on the WHO CC Latvia website: http://www.tblatvia.com/tb-training-2024/


Established in 2004, the WHO CC Latvia is an international center of excellence for building the capacity and expertise of health workers in the treatment and management of DR-TB. WHO CC Latvia has extensive experience in organising custom-tailored international courses, conferences and scientific/technical exchange visits, as well as experience in in-country capacity building and technical assistance, with a particular focus on countries in Eastern Europe and Central Asia. The director of the center is Dr. Liga Kuksa, who is also the chair of TBnet.

 

TBnet News

Editor – Irina Kontsevaya

Layout & formatting – Liga Rusmane

Cover picture – Christoph Lange




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