New treatment for Tuberculous Meningitis developed

Scientists have made a breakthrough that could save thousands of lives each year from Tuberculous Meningitis (TBM).

Researchers funded by the Wellcome Trust have been investigating TBM, a form of meningitis caused by the tuberculosis bacterium, and found that by combining traditional anti-tuberculosis drug treatments with an anti-inflammatory drug – dexamethasone - they can reduce the risk of death by 30%.

TBM kills or severely disables around a half of those who contract the disease. The researchers found that although dexamethasone reduced the risk of death, it did not reduce the numbers of severely disabled survivors. Approximately 15% of survivors were left with problems such that they would not be able to live without help from their families or carers.

The study, which was funded by the Wellcome Trust and conducted over four years at the Oxford University Clinical Research Unit in Vietnam, was focused on the treatment of 545 volunteers with TBM. All the patients received the best available drugs against the tuberculosis bacterium; approximately half also received dexamethasone.

When the two groups were compared, after nine months of treatment, those who were given dexamethasone had a significantly increased chance of survival. The programme focused on patients aged over 14 following previous findings that a similar treatment improved survival in children with TBM.

TBM is one of the most common and most dangerous forms of meningitis worldwide. It differs from other forms of meningitis (such as ‘meningococcal meningitis’, that often makes headlines in the UK) as it is slower to act and is much more difficult for doctors to diagnose. Each year around 80,000 people contract TBM, 28,000 of those die and a further 12,000 are left with severe disabilities. Although TBM is a global problem, it is particularly prevalent in the developing world.

Wellcome Trust research fellow, Dr Guy Thwaites, said:

"Tuberculosis Meningitis is a disease which can be a death-penalty for sufferers. Developing a treatment that's clinically proven to reduce deaths by such a significant margin is a giant leap forward.

“This is a major breakthrough in reducing fatalities from TBM, but we still need to develop treatments which lower the number of patients who develop severe disabilities. Many suffer stroke-like symptoms with loss of bodily functions and paralysis down one side of the body.

“We’re thrilled by the progress we've made, but will continue searching for new treatments.”

ENDS

Media contact:

Mark Anderson

Wellcome Trust

020 7611 8612

m.anderson@wellcome.ac.uk

Notes to editors:

1. The Wellcome Trust is an independent research funding charity established in 1936 under the will of the tropical medicine pioneer Sir Henry Wellcome. The Trust’s mission is to foster and promote research with the aim of improving human and animal health and it currently spends over £400 million per annum.

2. The paper ‘Dexamethasone for the treatment of Tuberculous Meningitis in adolescents and adults’, was published in the New England Journal of Medicine on 21 October 2004.