STREAM Stage 2

The Evaluation of a Standardised Treatment Regimen of Anti-Tuberculosis Drugs for Patients with MDR-TB

Can MDR-TB be successfully treated with a 9-month fully oral regimen or even with a 6-month regimen?

What is this study about?

STREAM Stage 2 is assessing two new short course regimens for multidrug-resistant tuberculosis (MDR-TB) in comparison with the 9-month regimen developed in Bangladesh which was evaluated in STREAM Stage 1.

In the 9-month oral regimen the new drug bedaquiline is given throughout treatment in place of the injectable kanamycin which frequently gives rise to unpleasant side-effects such as deafness. High dose moxifloxacin is replaced by levofloxacin to minimise potential cardiac side-effects such as QT prolongation.

The 6-month regimen has a shorter intensive phase, and as in the 9-month oral regimen bedaquiline is given throughout treatment and levofloxacin replaces moxifloxacin. Prothionamide and ethambutol have both been dropped.

The primary objective of the study is to assess whether the fully oral regimen is non-inferior to the 9-month regimen studied study in Stage 1.

Publications from this study

Moodley Riya, Godec Thomas R on behalf of STREAM Trial Team. Short-course treatment for multidrug-resistant tuberculosis: the STREAM trials. Eur Respir Rev 2015; 25: 29-35 [ERS Publications]

Type of study

Randomised trial

Contact details

Who is funding the study?

Stage 2 is funded by the United States Agency for International Development (USAID) and Janssen Pharmaceuticals and sponsored by The International Union Against Tuberculosis and Lung Disease.

When is it taking place?

The trial started in March 2016, recruitment was completed in January 2020. Results of the primary outcome are expected to be available by early 2021.

Where is it taking place?

Sites from Africa, Asia and Eastern Europe are participating.

Who is included?

Adult patients with rifampicin-resistant tuberculosis (RR-TB) who are sensitive to fluoroquinolones, such as moxifloxacin and levofloxacin, and to kanamycin, the aminoglycoside injectable.