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The STREAM trial: missed opportunities and lessons for future clinical trials | Journal Article / Commentary | MSF Science Portal
Journal Article
|Commentary

The STREAM trial: missed opportunities and lessons for future clinical trials

Loveday M, Reuter A, Furin J, Seddon JA, Cox HS
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Abstract
Final results of the STREAM trial were presented at the 2018, 49th Union World Conference on Lung Health, held in The Hague, The Netherlands. STREAM is a randomised controlled trial comparing the 18–24 month WHO-recommended multidrug-resistant tuberculosis (MDR-TB) treatment regimen with a 9–12 month regimen similar to that first described in Bangladesh. 1 Under programmatic conditions, the longer regimen results in treatment success for approximately 50% of patients, 2 whereas the shorter 9–12 month regimen improved treatment success to 80% or higher in selected countries. 3 , 4 Because these countries had relatively low HIV prevalence and relatively high percentages of treatment success with the longer regimens, questions around generalisability were raised. 4 STREAM was a multi-million dollar undertaking that took almost 10 years from the time of study design until the release of final results. Given the time and costs involved it is essential to reflect on lessons learned, and what the trial results tell us to inform how we accumulate future evidence to guide MDR-TB treatment.

Subject Area

tuberculosis

Languages

English
DOI
10.1016/S1473-3099(19)30106-9
Published Date
22 Mar 2019
PubMed ID
30910428
Journal
Lancet Infectious Diseases
Volume | Issue | Pages
Volume 19, Issue 4
Issue Date
2019-04-01
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