The long-term treatment outcomes for multidrug-resistant tuberculosis (MDR-TB) are significantly better than previously assumed. This is the result of a large national cohort study from Latvia, which was conducted in close cooperation with the German Center for Infection Research (DZIF) at the Borstel Research Center.

The scientists evaluated data from 1,299 adult patients who were treated for MDR or rifampicin-resistant tuberculosis in Latvia between 2005 and 2021. According to the conventional WHO criteria at the end of therapy, only 4.8 percent were considered cured. However, in a systematic long-term follow-up with linking national registry data, 76.9 percent remained permanently free of recurrence, according to the study published in the journal “The Lancet Regional Health – Europe”.

The analysis shows that the usual measurement of success at the end of treatment significantly underestimates the actual benefit for patients. The use of at least three effective drugs in the individual therapy regimen was particularly decisive for long-term success. Very short treatments of less than nine months would have associated an increased risk of relapse or death, while therapy durations of between ten and 17 months would have achieved comparable results to longer treatments, the researchers said. In the later years of the study period, the therapies had increasingly improved. Today, the duration of treatment for MDR-TB is approaching the six months of regular tuberculosis in many cases.

The results also underlined the important role of national expert committees (Consilia) in the selection of therapies. In Latvia, the recommendations of such bodies would have led to significantly better long-term results than the sole application of the WHO definitions. The researchers also see this as a contribution to the responsible use of antibiotics, which could reduce the emergence of new resistances.

The work thus provides important impetus for the further development of treatment strategies for multidrug-resistant tuberculosis. The scientists pleaded for greater consideration of individualized therapies and long-term aftercare. They called for further prospective studies to test the findings under the conditions of new, shortened therapy regimens with modern active ingredients. If necessary, the international definitions of treatment success in MDR-TB should be revised.

Original Paper:

Sophie Charlotte Meier et al.: Treatment outcomes and long-term relapse-free survival after multidrug-resistant tuberculosis treatment in Latvia: a retrospective national cohort study. The Lancet Regional Health – Europe, 2026. DOI: 10.1016/j.lanepe.2026.101676

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Editor: X-Press Journalistenbüro GbR

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