Harvard Study Unveils New TB Drug Regimens

A Harvard Medical School-led clinical trial has identified three highly effective drug regimens for drug-resistant tuberculosis (TB), marking a significant breakthrough in the fight against one of the world’s deadliest infectious diseases. The study, published in the New England Journal of Medicine, demonstrated that these all-oral treatments are safer, shorter in duration, and just as effective—if not more so—than existing therapies.

Tuberculosis remains a leading global health threat, particularly in its drug-resistant form, which fails to respond to rifampin, a key first-line antibiotic TB drug. Until now, treatments for multidrug-resistant TB (MDR-TB) have relied on long, toxic regimens that include painful daily injections.

The new study, part of the endTB project, offers a safer alternative, utilizing recently developed medications such as bedaquiline and delamanid to create effective 9-month regimens.

The clinical trial enrolled 754 participants across seven countries and tested five experimental drug combinations. Researchers found that three of these regimens achieved an 85-90% cure rate, surpassing the 81% success rate of the control group, which was treated with standard long-term therapy. These results indicate that shorter, injection-free treatment options can be implemented without sacrificing efficacy.

Another key advantage of the new regimens is their flexibility in cases of drug intolerance or supply shortages. By expanding the treatment arsenal, clinicians can now personalize care for patients, reducing side effects and improving adherence.

The study is part of a broader shift in tuberculosis treatment, as researchers worldwide aim to improve accessibility and effectiveness. The World Health Organization (WHO) has already included these regimens in its list of recommended treatments, recognizing their potential to transform TB care.

This research provides renewed hope for millions affected by rifampin-resistant and multidrug-resistant TB, ensuring that more patients have access to safe, effective, and affordable treatments.

More Information: Guglielmetti, L., et al. (2025) Oral Regimens for Rifampin-Resistant, Fluoroquinolone-Susceptible Tuberculosis.New England Journal of Medicine. doi.org/10.1056/NEJMoa2400327.