III期临床试验

筛选例,入选例。

随机分为三组:

第一组(对照组):isoniazid,rifampin,pyrazinamide,andethambutolfor8weeks,然后,isoniazidandrifampin18周;

第二组:isoniazid,rifampin,pyrazinamide,andmoxifloxacinfor17weeks,然后,9周空白对照;

第三组:moxifloxacin,rifampin,pyrazinamide,andethambutolfor17weeks,然后,9周空白对照。

观察治疗失败或复发率。

结论:

两个包含莫西沙星的治疗方案比对照组有更快速的细菌学阴转率,而且疗程缩短至4个月,也没显示出更劣的治疗效果。

KateJohnson

September07,

WASHINGTON—Hopesforanew,moxifloxacin-containingtuberculosis(TB)treatmentthatmighthaveshortenedtherapyfrom6to4monthssufferedasetbacktodaywiththeresultsofREMoxTBstudy,oneofthelargestphase3TBtrialsinhistory.

Butfindingsfromthestudyarenotalldisappointing,accordingtoleadinvestigatorStephenGillespie,MD,fromtheUniversityofSt.AndrewsMedicalSchool,inScotland.

Whiletheresultsarenotwhatwehadhopedfor,thetrialwilldramaticallyimproveknowledgeinthefieldandalsopavethewayforfutureTBtrials―especiallythosethatmightincludemoxifloxacinaspartoftheregimen,Dr.GillespietoldMedscapeMedicalNews.

TheresultswerereportedhereattheInterscienceConferenceonAntimicrobialAgentsandChemotherapy(ICAAC)andpublishedsimultaneouslyintheNewEnglandJournalofMedicine.

FailuretoShowNoninferiority

TheREMoxTB(RapidEvaluationofMoxifloxacininTuberculosis)trialinvestigatedwhetherreplacing1ofthefirst-lineTBdrugs(isoniazid,rifampicin,pyrazinamide,orethambutol)withashortercourseofmoxifloxacinwasnoninferiortostandardtreatment.

Thetrialrandomlyassignedpatientswithdrug-sensitiveTBtoacontrolgroup,whichreceivedisoniazid,rifampin,pyrazinamide,andethambutol(Myambutol,STIPharmaLLC)for8weeks,followedby18weeksofisoniazidandrifampin,orto2separatemoxifloxacin-containingarms:1thatreplacedethambutolwithmoxifloxacinfor17weeks,followedby9weeksofplacebo(INHarm),andonethatreplacedisoniazidwithmoxifloxacinfor17weeks,followedby9weeksofplacebo(ETHarm).

Theprimaryendpointofthenoninferioritytrialwastreatmentfailureorrelapsewithin18monthsafterrandomization.

Thestudyfailedtoshownoninferiorityofthemoxifloxacinregimens







































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