A CONTROLLED CLINICAL-TRIAL OF SHORT-COURSE CHEMOTHERAPY FOR TUBERCULOMA OF THE BRAIN

Objective: The efficacy of a short-course regimen in the treatment of brain tuberculoma and computerised tomography (CT) scan appearance bef ore, during and after antituberculosis treatment was studied in a cont rolled clinical trial. Design: Patients aged over 5 years with tubercu loma of the brain diagnosed by CT scan were randomly allocated to one of the following 2 regimens: Regimen 1: rifampicin, isoniazid and pyra zinamide daily for an initial 3 months followed by rifampicin and ison iazid twice-weekly for 6 months. Regimen 2: rifampicin, isoniazid and pyrazinamide thrice-weekly for an initial 3 months followed by rifampi cin and isoniazid twice-weekly for 6 months. The patients were followe d intensively for 2 years from the start of treatment. Results: Of the 108 patients analysed (regimen 1:56, regimen 2:52), at the end of tre atment clinical status was normal in 91% in regimen 1 and 88% in regim en 2, Of the 91 patients with scan assessments, CT scan lesions disapp eared at 24 months in 77% of 47 patients in regimen 1 and 80% of 44 in regimen 2, and in both groups 88% of the patients were clinically nor mal, None had relapses requiring treatment. Conclusions: Short-course regimens of 9 months' duration are effective in the treatment of tuber culoma of the brain; clinical recovery was faster than scan clearance.