“This new therapy will greatly improve our ability to prevent TB and will make a big difference in the lives of our patients,” said Dr. Gonzalo Alvarez, scientist and head of respirology at The Ottawa Hospital, consultant respirologist for Nunavut and associate professor at the University of Ottawa.A transformational treatment for latent tuberculosis (TB) is now the standard of care in Canada, thanks to research led by The Ottawa Hospital.
The Canadian Thoracic Society’s new Canadian TB Standards, released on March 24, 2022, recommend 3HP (rifapentine and isoniazid) as a first-line treatment for most people with latent TB. International studies have shown that 3HP can eliminate latent TB with a weekly dose for 12 weeks, compared to the traditional drug, isoniazid, which requires daily dosing for nine months.
Dr. Gonzalo Alvarez, scientist and head of respirology at The Ottawa Hospital and consultant respirologist for Nunavut, led the first 3HP studies in Canada starting in 2016. This research resulted in the Government of Canada adding 3HP to the list of drugs for urgent public health need in 2018.
Dr. Alvarez’s most recent study, published in the International Journal of Infectious Diseases, included 2,803 patients treated at The Ottawa Hospital for latent TB before and after 3HP became available.
The study showed that 90% of patients who took 3HP completed the therapy, which allowed the overall completion rate in the clinic (including 3HP and traditional treatments) to improve by 19%. As 3HP becomes the standard, it is hoped that that completion rates will continue to improve.
This research, combined with Dr. Alvarez’s Taima TB 3HP study in Nunavut, resulted in the new recommendation that 3HP be used as a first-line treatment in most cases.
“This new therapy will greatly improve our ability to prevent TB and will make a big difference in the lives of our patients,” said Dr. Alvarez, who is also an associate professor at the University of Ottawa.
This study was funded by the Public Health Agency of Canada and supported by the Ottawa Methods Centre.
Researchers at The Ottawa Hospital, including Dr. Alvarez and Dr. Chris Pease, also contributed to a chapter in the new Canadian TB standards on cultural competence for healthcare workers and public health professionals serving Indigenous peoples of Canada as well as the guidelines for the diagnosis and treatment of latent TB.
According to the World Health Organization, TB sickens approximately 10 million people each year and kills 1.5 million worldwide. Despite relatively low rates of active TB in Canada overall, it persists as a major public health threat for Inuit living in the North. Overall, 20% of Canada’s TB cases occur in Indigenous Peoples, with 70% in immigrants and refugees. The government of Canada has pledged to eliminate TB among Inuit in Canada by 2030.
The Ottawa Hospital is a leading academic health, research and learning hospital proudly affiliated with the University of Ottawa and supported by The Ottawa Hospital Foundation.
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