Application of whole genome sequencing in tuberculosis clinical trials

Published on July 28, 2021   31 min

Other Talks in the Category: Clinical Medicine

0:00
Hello, my name's Stephen Gillespie. I'm the Sir James Black Professor of Medicine at the University of St. Andrews. I'm going to talk today about the application of whole genome sequencing in tuberculosis clinical trials.
0:14
In this talk, I will introduce the basic concepts of the tuberculosis clinical trial. After providing a background of the evolution of typing techniques apply to microbacteriology, I will show the way in which genome sequencing can assist in performing clinical trials better. The areas covered will include defining relapse and reinfection, detecting mixed infection, using genomics to understand the significance of post-treatment positives and conclude with some observations, and how this exciting technology could be applied more widely in clinical trials.
0:51
This image represents the overview of the REMoxTB clinical trial, the first of the modern-day studies using regulatory methods and genomic techniques to contribute to the result. Here you can see the treatment plans for the study which compares the standard isoniazid, rifampicin, ethambutol and pyrazinamide regimen with two experimental regimens that substitute moxifloxacin and fluoroquinolones for either ethambutol or isoniazid. The patients are treated for four or six months and are followed for a year after the completion of treatment. All of the patients had to be culture-positive to be included in the analysis. In total, the patients attended 16 visits over their participation in the trial. The isolates from patients who either failed on treatment or had an apparent recurrence were collected as indicated.
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Application of whole genome sequencing in tuberculosis clinical trials

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