TB Journal Club

Join us next on Thursday 24th July at 4pm when the ID team @LNWH_NHS will be hosting!

Limitations discussed included serum preparation means not truly POC, no TST+ controls, cannot detect rif resistance, arguably essential for any novel diagnostic, although the authors have found it can be adapted to detect resistant strains (? with ⬇️ sens).

This month Dr Iman Raza chaired by @hanifesmail_tb from @UCLTB presented a TB diagnostic study of LIT-TB, a lab-in-tube system with a portable reading device that targets IS6110 cell-free DNA using recombinase polymerase amplification and CRISPR-Cas12a: tinyurl.com/2yv4peoc

The May TB Journal Club takes place *tomorrow* Thursday 29th, 4pm UK time. Liv-TB will be taking us through tinyurl.com/vn7995ke trial of pyrazinamide dosing, safety & efficacy. Look forward to seeing you there! #tuberculosis #TB

Discussion focussed on the clear importance of Bdq containing regimens, the concerning rise of Bdq-resistance, the poor outcomes associated with it (shorturl.at/q6VUY), and the importance of regimens to preserve Bdq. Join us next month with @NaomiTropMed 22nd May 4pm!

n=699. 1˚ endpoint favourable outcome @ W73. 12% non-inferiority margin. Pregnancy at enrolment was exclusion. 14% PWH, 57% cavitatory dis. DCMZ non-inferior in mITT only. Phenotypic pyraz resistance >50%. SAE similar across groups, no deaths considered related to study drugs.

This month @mnoursad & @UCLTB presented EndTB's RCT on oral regimens for FQ-sensitive RR-TB www-nejm-org.iclibezp1.cc.ic.ac.uk/doi/full/10.10… This 7-country 6-arm open-label Phase III RCT in adults (≥15y) found 9m BLMZ, BCLLfxZ and BDLLfxZ non-inferior to WHO SOC; 1ry endpoint favourable outcome at W73.

❗Final #tuberculosis #TBJC of 2024 🕓Thurs November 28, 4pm UK 🏛️Hosts: @StGeorgesUni . Chair: @SeanWasserman Presenter: Sharenja Ratnakumar 💊 shorturl.at/jcijg long-term efficacy & safety from STREAM2 trial of shorter regimens for #DRTB Hope to see you there!

72% would prioritise further research into NAC for individuals with TB - and we were lucky to be joined by @BNadjm who was able to tell us more about plans for a further upcoming trial 🇹🇿🇬🇲🇲🇿 Thanks so much to all who attended and contributed - see you next month.

This Halloween @Mimi_Malhotra & @NaomiTropMed @LSTMnews took us to the spine-chilling world of post-TB lung disease👻 via this RCT of adjunctive NAC shorturl.at/UBXwJ In our straw poll, 11% would consider NAC for their TB patients; 22% said no and 67% wanted more evidence.

TB Journal Club - THIS Thursday October 31st🎃1600 UK 🕓 @Mimi_Malhotra & @NaomiTropMed from @LSTMnews will be taking us through recent 🇹🇿@NEJMEvidence RCT of adjunctive NAC in #tuberculosis evidence.nejm.org/doi/full/10.10… See you there!

In this correspondence in @LancetRespirMed we highlight the challenges of inferring TB preventive therapy effectiveness from observational studies: thelancet.com/journals/lanre… A product of the September @Tb_JournalClub... great forum for discussion @JamesGB_ @mnoursad

General discussion: remains important to know differential diagnosis (?malaria ?viral) in different settings, temptation with TDA to maximise sensitivity and risk over-treatment, but this can miss other diagnoses. Join us on 31st October for the next JC hosted by @LSTMnews!

Limitations: gap between admissions over study period (1,906) and enrolments (603) ?any bias, inclusion of GXP in TDA despite definitive diagnostic, challenges acquiring all results in reasonable time in real-world setting, lack of gold standard (3/4).

Thanks to @JamesSeddon10 and Ola Joseph yesterday who discussed thelancet.com/journals/eclin… Study in Zambia and Uganda in 603 children offers a one-step (AUC 0.91, Se 86%, Sp 81%) and two-step TDA for initiating TB Rx in hospitalised <5s with sev. malnutrition.

Reminder of next TB JC - tomorrow at 4pm! ncbi.nlm.nih.gov/pmc/articles/P…

Next #TBJC: Thurs 3 Oct at 4pm UK🕓, hosted by @imperialcollege Presenter: Dr Ola Joseph Chair: @JamesSeddon10 Paper: ncbi.nlm.nih.gov/pmc/articles/P… by @cchabala0407 et al: treatment algorithms for #tuberculosis in <5y with severe malnutrition in Zambia & Uganda