Highlights from the 2023 Union World Conference on Lung Health

After three years being held virtually due to the COVID-19 pandemic, the 2023 Union World Conference on Lung Health took place in-person on 15-18 November 2023 in Paris, France under the theme ‘Transforming evidence into practice’. The official press releases, giving an overview of a number of important TB studies presented at the Conference, can be accessed here. The Union World Conference on Lung Health, convened annually by the International Union Against Tuberculosis and Lung Disease (The Union), is the world’s largest gathering of clinicians and public health workers, health program managers, policymakers, researchers, affected communities and advocates working to end the suffering caused by lung disease, with a focus specifically on the challenges faced by low- and lower-middle income populations.

Selected highlights

endTB: Landmark clinical trial redefines multidrug-resistant TB treatment options

The endTB clinical trial results presented at the 2023 Union World Conference on Lung Health revealed evidence to support the use of four new, improved, all-oral regimens to treat multidrug- or rifampicin-resistant TB (MDR/RR-TB). Three of the regimens have shown similar efficacy and safety to conventional MDR-TB treatment while reducing treatment time to 9 months. The fourth regimen could be used effectively as an alternative for people who cannot tolerate bedaquiline or linezolid. If recommended by the World Health Organization, these new treatment regimens would empower clinicians to offer shortened MDR-TB treatment regardless of age, pregnancy, and comorbidities. For further details about the endTB clinical trial results, download a leaflet here, watch a short video here, visit endTB.org.

Levofloxacin: New treatment safely prevents multidrug-resistant TB

Two clinical trials results presented at the 2023 Union World Conference on Lung Health showed that an oral antibiotic taken for six months once-daily substantially reduced the risk of developing multidrug-resistant TB (MDR-TB). The TB-CHAMP Phase 3 clinical trial tested levofloxacin in children as part of the BENEFIT Kids project and showed it safely reduced the risk of developing MDR-TB disease in children by 56%. The V-QUIN Phase 3 clinical trial tested levofloxacin in adults and adolescents and found it reduced the risk of developing MDR-TB disease in adults and adolescents by 45%. Both pieces of research are expected to guide World Health Organization recommendations for preventing MDR-TB in children and adults anticipated in the coming months. In addition, results of PERFORM, CATALYST, and ChilPref studies were presented, exploring the pharmacokinetics, safety, tolerability and acceptability of child-friendly formulations of key drugs used in treating MDR-TB (levofloxacin, clofazimine, moxifloxacin and linezolid).

BPaL: High cure rate with drug-resistant TB regimen

The interim results of the LIFT-TB operational research from five Central and Southeast Asian countries (Indonesia, Kyrgyzstan, the Philippines, Uzbekistan, and Vietnam) showed that the new, shorter drug-resistant TB (DR-TB) treatment regimen – BPaL (comprised of bedaquiline, pretomanid, and linezolid) – had a 94.5% cure rate in countries with a high DR-TB burden. Interim results of this research, along with results from the Ukraine program, were presented at the 2023 Union World Conference on Lung Health, in addition to four abstracts from the Philippines on additional advantages of the BPaL regimen. LIFT-TB program provides funding, resources, technical assistance, and wide-ranging expertise from multiple partners for seven countries (Indonesia, Kyrgyzstan, Myanmar, the Philippines, Ukraine, Uzbekistan, and Vietnam) to advance the implementation and rollout of the BPaL regimen. BPaL and BPaLM (comprised of bedaquiline, pretomanid, linezolid, and moxifloxacin) were officially recommended by the World Health Organization for all patients with multidrug- or rifampicin-resistant TB in 2022.

TBAJ-876: TB Alliance launches five-country Phase 2 clinical trial evaluating next-generation TB drug

TB Alliance launched a new Pan-Phase 2 clinical trial incorporating elements of Phase 2a, b and c, identified as NC-009, to evaluate the safety and efficacy of a combination of a new experimental compound, TBAJ-876, with pretomanid and linezolid, components of TB Alliance’s BPaL regimen (comprised of bedaquiline, pretomanid, and linezolid). This new regimen has the potential to become a ‘universal TB regimen’, shortening and improving treatment for both drug-sensitive and drug-resistant TB. Results from preclinical and Phase 1 studies presented at the 2023 Union World Conference on Lung Health showed that the new compound, when compared with bedaquiline (a TB medicine in the same drug class), eliminated TB bacteria faster and had a potentially safer profile.

Longhorn Vaccines and Diagnostics presents targeted vaccine approach for Mycobacterium tuberculosis with LHNVD-301

Longhorn Vaccines and Diagnostics presented new data from an animal study of LHNVD-301, the company’s lead TB vaccine candidate. The data showed that a Mycobacterium tuberculosis vaccine could generate broader protection against other pathogens susceptible to antimicrobial resistance. The study was presented at the 2023 Union World Conference on Lung Health.

For more TB news, check out the latest edition of the TB Online Weekly Newsletter (#36, 23 November 2023) with the latest TB advocacy and research updates.