Language
English
Publication Date
1-1-2025
DOI
10.3389/frabi.2025.1570989
PMID
40475250
PMCID
PMC12140437
PubMedCentral® Posted Date
5-22-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Tuberculosis drug trials are primarily designed to identify antibiotic regimens with the strongest potency to kill Mycobacterium tuberculosis. However, microbiologic cure is not synonymous with improved health and recovery. Beyond antimicrobial efficacy, parameters such as morbidity and mortality related to lung function, cardiovascular health, and cancer should be prioritized. This narrative review emphasizes the critical need to emphasize clinical outcomes as much, if not more, than microbiological endpoints. We examine the underlying pathophysiological mechanisms and determinants of non-microbiological outcomes in tuberculosis, providing a synthesis of current knowledge. While there is growing evidence for some biomarkers to risk stratify TB patients for risk of all-cause mortality, relapse, or lung damage, no evidence was found on TB-associated cancer or cardiovascular disease. In addition to monitoring microbiologic outcomes, clinical trials and treatment cohorts need to capture patient-centered health dimensions more broadly. Finally, we highlight key research gaps and opportunities to evaluate non-microbiological biomarkers, aiming to improve patient monitoring and enable stratified approaches to tuberculosis management.
Keywords
tuberculosis, biomarker, cardiovascular, sequelae, cancer
Published Open-Access
yes
Recommended Citation
DiNardo, Andrew R; Sabiiti, Wilbert; Gillespie, Stephen H; et al., "Inclusion of Patient-Centered, Non-Microbiological Endpoints and Biomarkers in Tuberculosis Drug Trials" (2025). Faculty and Staff Publications. 4695.
https://digitalcommons.library.tmc.edu/baylor_docs/4695