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Table 2 Modelled regimen properties and their minimal and optimal scenarios. While the full-target product profile published by WHO [9] lists an extended series of regimen attributes, for the purpose of the current modelling analysis, we distilled these to the limited set of properties shown here, that would be most relevant to the transmission impact of a future regimen. ‘Minimal’ and ‘Optimal’ values for regimen properties were identified through expert opinion from the experts involved in the WHO target product profiles: they represent the range between minimally acceptable performance parameters for a future preventive treatment regimen to be licensed and recommended, and on the other hand, ideal but achievable regimen properties. Footnotes: (i) In the main text, we assumed that regimens would have half the efficacy against rifampicin-resistant TB infection, compared to their efficacy against drug-sensitive infection: in sensitivity analysis, we modified this assumption to 25% and 75%. (ii) 100% efficacy is likely to be infeasible to be achieved in practice, but is stated here as an aspirational target. (iii) Ease-of-adherence incorporates a range of regimen properties listed in the WHO target product profiles, including pill burden, dosing frequency, and safety and tolerability. As discussed in the main text, further evidence is needed to understand quantitatively how each of these regimen properties drives ease-of-adherence. (iv) To avoid an overly optimistic role of forgiveness, we assumed in the main analysis that forgiveness only applies to those completing at least 50% of the regimen (and that any less is associated with essentially zero forgiveness). In sensitivity analysis, we adjusted this threshold to 25% and 75% (see Additional file 7: Table S9, and Fig. S14)

From: Prioritising attributes for tuberculosis preventive treatment regimens: a modelling analysis

Regimen property

How it is quantified

Future PT regimen

Minimal

Optimal

Regimen duration

Duration of administration of the regimen (months)

3

1

Efficacy against drug-sensitive TB (modelled as emergent property of ‘hidden’ mechanistic properties including proportion bacteriologically cured, and strength and durability of non-curative protection)

Efficacy measured as reduction in incidence among those with TB infection that would be observed under trial conditions at two-year post-regimen follow-up, in a cohort receiving the regimen vs a hypothetical cohort receiving placebo (see Methods for further technical details of cohort modelling) (i)

70%

100% (ii)

Ease-of-adherence

Proportion successfully completing the regimen under programmatic conditions (iii)

80%

90%

Forgiveness

Amongst those completing at least half of the regimen before interrupting, the proportion that nonetheless have the same outcomes as those completing the full regimen (iv)

50%

80%

Barrier to resistance

Amongst those having rifampicin-sensitive infection, the proportion that do not develop resistant infection as a result of preventive treatment

95%

100%