Multicentre randomised phase II trial evaluating anti-TNF therapy to reduce mortality associated with tuberculous meningitis in HIV-1 infected patients
Tuberculous meningitis (TBM) is an infectious disease caused by a bacterium called Mycobacterium tuberculosis or Koch’s bacillus. It is the most serious form of tuberculosis (TB), affecting the brain and spinal cord, with around 164,000 new cases each year worldwide. In people living with HIV (PLHIV), mortality is as high as 50% despite treatment, and neurological sequelae are common.
In meningeal tuberculosis, there is an imbalance in the immune system’s response, with an excessive inflammatory response against the tubercle bacillus, which contributes to worsening the symptoms.
Anti-TNFs are immunomodulating drugs usually used to treat inflammatory bowel disease or rheumatoid arthritis. They have also been used in a few cases to treat severe inflammatory responses in tuberculosis, but no clinical trial to date has evaluated the benefits of these treatments on mortality linked to TBM during HIV infection. Adalimumab is one of the most widely used anti-TNF treatments.
The primary objective of the TIMPANI trial is to evaluate whether the addition of adalimumab treatment can reduce mortality in HIV-infected patients with meningeal tuberculosis.
Vanessa Machault
vanessa.machault@u-bordeaux.fr
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