Putting the patient at the centre of tuberculosis management


  • The UTE is participating in a European project that aims to design a new medical algorithm for tuberculosis treatment management.
  • The project, Stratified Medicine Algorithm for host-directed therapy in tuberculosis (SMA-TB, GA 847762), will run a clinical trial to test the impact of aspirin as an adjunct to standard TB therapy.
  • The project is one of only 10 granted by the European Union in all of Europe in the area “prevention, treatment and cure of infectious diseases” in the last call for the Horizon 2020 Programme.

Tuberculosis, known as TB, is a disease caused by TB bacteria that attack the lungs and it can persist throughout a person’s life or even kill them. The new Stratified Medicine Algorithm for HDT in TB (SMA-TB, GA 847762) Project is being led by the Germans Trias i Pujol Research Institute (IGTP) in Spain and will be carried out by eight institutions in France, Georgia, Germany, the Netherlands, Norway, South Africa and Spain. The (name of group) led by (name of leading scientist) from the (name of institution) will play an important part and will be primarily responsible for working on (work packages assigned to your institution). The project has a total funding of 6.3 million euros and will run for four and half years.

“Host-directed treatments (HDTs) are a new type of complementary therapy based on boosting the patients’ own defences and ability to fight off disease. In the case of tuberculosis this complements the effect of the antibiotics, which only eliminate the microorganisms which cause it, but do nothing to reduce damage to the lungs” explains Cristina Vilaplana, researcher at the UTE (IGTP) and CIBERES and coordinator of SMA-TB.

The standard treatment for people infected with TB is the same for everybody. It is very long and its success depends on whether the particular strain of bacteria in that patient can be treated by the available drugs. Resistant strains (MDR- and XDR-TB) are not killed by the common drugs and are much more difficult to treat, which makes the treatment much longer and more unpleasant for patients who can also be left with worse long-lasting and some times life-long effects.

Host-directed treatments (HDTs) boost the patient’s defences and ability to fight off the disease rather than just killing the bacteria. TB patients suffer lung damage and the patients who are worst affected suffer from runaway inflammation in their lungs and damage that can remain even after they are cured. If HDTs can be included in the medicines that the patients are already taking, this could reduce the inflammation and mean that the length of the treatment would be shorter and the amount of lung damage would be much reduced.

To achieve these aims, the SMA-TB Project aims to do three things:

  • It will run a high-quality clinical trial including patients in several countries, in which patients being treated for TB are also given aspirin, to reduce inflammation. The trial will include patients whose TB is sensitive to the normal drug therapy and patients whose TB is resistant to this treatment. The researchers expect to show that the use of aspirin means the time of the treatment is shorter and that patients suffer less lung damage.
  • Part of the research will identify biomarkers that doctors can use to reliably stratify patients and predict who can be treated successfully by the standard treatment and who will need to complete the drug treatment with HDT. It will also study the prognosis and outcomes for patients in different groups. Data from very large numbers of patients will be collected in the European project and network-based mathematical modelling will be used to identify patterns in the data.
  • Combining the information on stratifying patients and outcomes for different cases the researchers will produce a medical algorithm to be applied to new patients. This will allow doctors to predict the course of the disease and apply the best clinical management in each case.

The overall objective of the project is that instead of the current one-size-fits-all model, TB patients will receive a more personalized treatment. This will mean that more people are cured more quickly, but it will improve the quality of life for people being treated for tuberculosis infection.

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