From: A systematic review of endpoint definitions in late phase pulmonary tuberculosis therapeutic trials
Trial event | Outcome timing | Outcome timing | |||
---|---|---|---|---|---|
During/at the end of treatment [# of studies reporting] | At the end of follow-up [# of studies reporting] | During/at the end of treatment [# of studies reporting] | At the end of follow-up [# of studies reporting] | ||
Favorable outcomes | |||||
Start with negative culture | 2 | ||||
Defined by one negative culture: “culture negative” at specified time | 2 | 12 | |||
Culture(-) not having been retreated or had tx changed or extended | 2 | ||||
Defined by two negative cultures, with varying intervals between cultures | 1 | 12 | |||
Defined by three negative cultures | 2 | 2 | |||
Defined by all negative cultures in specified time period | 1 | ||||
Inability to produce sputum addressed, with various qualifications | 10 | ||||
No signs/symptoms and can’t produce sputum | 2 | ||||
No signs/symptoms and sputum is contaminated in 2 cultures with no evidence of TB | 2 | ||||
Incomplete culture results but clinical symptoms favorable | 2 | ||||
Relapse-free cure | 2 | ||||
Unfavorable outcomes | Outcome not assessable | ||||
Biologically defined | |||||
Never convert to culture negative | 2 | 1 | |||
Do not have negative status, inconsistent qualifications | 6 | ||||
Persistently positive after specified time | 1 | ||||
Culture positive, confirmed by second (+) sample ≥ 4hr after first (+) culture | 2 | ||||
Two or more (+) cultures at least 1 month apart after 2mos in study and still on tx | 2 | ||||
Culture positive at end | 4 | 2 | |||
≥ 1 of last two cultures on separate occasions are (+) | 1 | ||||
Culture of ≥20 colonies | 1 | ||||
≥ 2 (+) cultures in last month, one of which is 20 colonies or more | 2 | ||||
Clinical failure at end, regardless of culture | 2 | 5 | |||
Recurrence: Relapse, varying qualifications | 2 | 29 | |||
Recurrence: Reinfection with a different strain | 2 | 3 | 13 | ||
Death | |||||
Any cause | 5 | 7 | 2 | 2 | |
TB-related | 11 | 14 | |||
Death from extra-pulmonary TB | 1 | ||||
Any non-TB-related death | 1 | 1 | 4 | 3 | |
Non-TB, except accident, violence, trauma | 7 | 7 | 9 | 1 | |
Non-TB, except suicide | 6 | 6 | 3 | ||
Death from a different TB strain | 1 | ||||
Died with last culture negative | 5 | ||||
Withdrawn and lost to follow-up | |||||
Did not reach endpoint, varying qualifications | 13 | ||||
No culture result at end of FU or last culture contaminated | 2 | ||||
Culture (+) when last seen | 4 | 4 | |||
Any withdrawal of or loss to follow-up | 2 | 4 | 2 | 2 | |
Left study with last culture negative | 2 | 7 | |||
Treatment issues | |||||
Extension, with varying exceptions | 11 | 2 | |||
Restart, with varying exceptions | 11 | ||||
Change treatment, with varying exceptions | 10 | 2 | |||
Initiation of treatment for relapse in absence of culture confirmation | 1 | ||||
Change one drug, with varying exceptions | 5 | 3 | |||
Change more than one drug | 5 | 4 | |||
Discontinue treatment, with exceptions | 10 | 9 | |||
Discontinue treatment, due to pregnancy | 2 | ||||
Incomplete, with varying qualifications | 5 | ||||
Off-protocol drugs | 3 | 3 | 1 |