Evidence map›Paper›PMID 36514153›Full record

ArticleTrials2022

Safety, effectiveness, and adherence of a short and all-oral treatment regimen for the treatment of rifampicin-resistant tuberculosis in Niger: a study protocol of a pragmatic randomised clinical trial with stratified block randomisation.

Mahamadou Bassirou Souleymane, Tom Decroo, Alphazazi Soumana, Ibrahim Maman Lawan, Assiatou Gagara-Issoufou, Souleymane Halidou-Moussa, Nimer Ortuño-Gutiérrez, Eric Adehossi, Saïdou Mamadou, Armand Van Deun and 1 more

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Article
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  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Mahamadou Bassirou SouleymaneDamien Foundation, Niamey, Niger. bachirsoul@gmail.com.
Tom DecrooInstitute of Tropical Medicine, Antwerp, Belgium.
Alphazazi SoumanaProgramme National de Lutte contre la Tuberculose, Programme, Niamey, Niger.
Ibrahim Maman LawanDamien Foundation, Niamey, Niger.
Assiatou Gagara-IssoufouUniversité Abdou Moumouni de Niamey, Faculté des Science de la Santé, Niamey, Niger.
Souleymane Halidou-MoussaHopital National Amirou Boubacar Diallo, Pneumo-phtysiologie, Niamey, Niger.
Nimer Ortuño-GutiérrezDamien Foundation, Brussels, Belgium.
Eric AdehossiUniversité Abdou Moumouni de Niamey, Faculté des Science de la Santé, Niamey, Niger.
Saïdou MamadouUniversité Abdou Moumouni de Niamey, Faculté des Science de la Santé, Niamey, Niger.
Armand Van DeunIndependent Consultant, Leuven, Belgium.
Alberto PiubelloDamien Foundation, Niamey, Niger.
Abdou Moumouni University · NEUnited Nations Children's Fund Niger · NENational Hospital Niamey · NEResearch Foundation - Flanders · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRifampicin-resistant tuberculosis (RR-TB) treatment requires combination treatment, which frequently causes serious adverse events and globally results in not much more than 60% treatment success. In Niger, a high cure rate was obtained with a RR-TB treatment strategy based on a second-line injectable drug (SLID)-containing Short Treatment Regimen (STR), with linezolid replacing the SLID in patients with ototoxicity. Given the availability of novel anti-tuberculosis drugs, WHO recommends all-oral RR-TB treatment. Considering the high level of success with the Niger treatment strategy, it would only be justified to replace it in case robust evidence shows that the WHO all-oral bedaquiline/linezolid (BDQ/LZD)-containing STR (experimental arm) performs better than the Niger RR-TB treatment strategy, (control arm) in terms of safety, effectiveness and adherence.

methodsA pragmatic randomised clinical trial (RCT) using stratified block randomisation, conducted between April 2021 and March 2024, prospectively enrols participants diagnosed with RR-TB in one of the four RR-TB units of the nation. Depending of the month in which patients are diagnosed with RR-TB, patients with FQ-susceptible RR-TB are enrolled in either the experimental arm or control arm. DISCUSSION: To increase the feasibility of conducting a RCT, embedded in routine activities of all Niger's RR-TB Units, we used a creative trial design. We randomised by monthly blocks, whereby the regimen used changes every month, using the month of RR-TB diagnosis as stratifying variable. This approach was deemed feasible for Niger's national tuberculosis programme, as it simplifies the work of the clinicians running the RR-TB units. Our creative design may serve as an example for other national programs. Findings will inform national and international RR-TB treatment guidelines, and will also strengthen the evidence-base on how to develop robust RR-TB treatment regimens.

trial registrationPan African Clinical Trial Register PACTR202203645724919 . Registered on 15 March 2022.

Indexed as

Tuberculosis, Multidrug-ResistantTuberculosis, PulmonaryAntitubercular AgentsHumansLinezolidNigerPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicRifampinAntitubercular AgentsLinezolidRifampinAll oral treatmentNew anti-tuberculosis drugsNigerRifampicin resistance tuberculosis

Identifiers

PMID36514153
PMCPMC9746149
OpenAlexW4311372987

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.