MUSC Investigators lead research efforts to improve TB treatment and prevention

In recent years, the Division of Infectious Diseases within the Department of Medicine has made global health a priority by implementing a number of initiatives dedicated to reducing health disparities in South Carolina and around the world. Leading the charge is Susan Dorman, M.D., a pioneer in the field who was recruited to MUSC from Johns Hopkins University in 2017 to strengthen and expand the Infectious Diseases Global Health program.

Dr. Dorman, who has dedicated her career to studying Tuberculosis (TB), serves as a TB medical consultant for the South Carolina Department of Health and Environmental Control and leads research efforts to improve TB treatment and prevention.

TB is a deadly infection that occurs in every part of the world. and the leading infectious disease killer aside from COVID-19. While TB is curable and preventable, multidrug-resistant TB remains a top public health threat.

“In the U.S. and around the world, tuberculosis mainly affects populations that experience greater obstacles to health and health care,” Dr. Dorman explained. “For example, in the U.S., the percentage of people with tuberculosis who are Black or African American and the percentage of people with tuberculosis who are Hispanic or Latino are higher than expected based on the percentages of these populations in the overall U.S. population.”

Dr. Dorman’s team is working across the diagnostics and therapeutics pipelines to bring new approaches to diagnosis and treatment to the people that can benefit from them. Their work emphasizes tuberculosis diagnostics that are easy to use at point-of-care and inexpensive, yet have the high diagnostic accuracy of the more cumbersome, centralized, expensive diagnostics currently used in practice.

“Shortening the treatment time improves adherence, decreases costs to programs and decreases the burdens on patients themselves,” explained Dorman.

Dorman and her team at MUSC worked with both a Centers for Disease Control and Prevention (CDC) and a National Institutes of Health trials group to find a way to shorten the overall duration of treatment needed to cure the disease completely.

The team focused on a drug called rifapentine. Over the course of 15 years, Dorman and her team performed preclinical and early phase clinical studies to determine how best to use this drug. They then launched a worldwide phase III study with the TB Trials Consortium and the AIDS Clinical Trials Group.

The results of the trial revealed that the four-month regimen containing rifapentine and another antibiotic, moxifloxacin, worked just as well as the six-month regimen. It was also safe and well-tolerated by the patients.

Dr. Dorman and her team hope these results will change how TB is currently being treated.

“This work really represents a landmark in tuberculosis care, and some of the scientific work embedded in this trial will help us and others to understand how to improve TB treatment even more,” said Dorman. “Four months is still too long - the real goal is to shorten tuberculosis treatment to one month or less -- that would really help people get back to their work and lives faster and avoid the personal/family economic devastation that often is a result of tuberculosis.”