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Author manuscript; available in PMC 2026 January 06. |\n| --- |\n| Published in final edited form as:\u003Cbr>N Engl J Med. 2025 December 18; 393(24): 2434–2446. doi:10.1056/NEJMoa2502866 .\u003Cbr>Randomized Trial of High Dose Oral Rifampicin in Adult Tuberculous Meningitis\u003Cbr>David B Meya, MBChB PhD\\#1,2 , Fiona V Cresswell, MBChB PhD\\#1,3,4 , Biyue Dai, PhD5 , Nicole Engen, MS5 , Kogieleum Naidoo, MBChB PhD6,7 , Ahmad Rizal Ganiem, PhD8,9 , Darma Imran, MD 10 , Mable Kabahubya, MPH 1 , Richard J Lessells, MBChB PhD6,11 , Vycke Yunivita, PhD9,12 , Riwanti Estiasari, MD PhD 10 , Lillian Tugume, MBChB MMED 1 , Bongeka Hlabisa, MBChB6 , Media Yuni Kurniawati, MD 13,14 , Noveline Sagita, MD 15 , Enock Kagimu, MBChB 1 , Kartika Maharani, MD 10 , Jane Gakuru, MBChB 1 , Maula N. Gaharu, MD 16 , Timothy Mugabi, MBChB 1 , Sarah Kimuda, MBChB 1 , Suzan Namombwe, MBChB 1 , Lindsey te Brake, PhD 17 , Rob Aarnoutse, PhD 17 , Elin M Svensson, PhD 17,18 , Ananta S Bangdiwala, MS5 , Sylvia Namanda, PGDip 1 , Nathan C Bahr, MD5 , Abdu K Musubire, MBChB 1 , Mahomed Yunus Suleman Moosa, PhD 19 , Raph L. Hamers, MD PhD20,21 , Suzaan Marais, FC Neurol (SA) PhD22 , David R Boulware, MD\\#2 , Reinout van Crevel, MD PhD\\#21,23,24 , Rovina Ruslami, PhD\\#9,12 on behalf of On behalf of the HARVEST Trial Team\u003Cbr>1 Infectious Diseases Institute, College of Health Sciences, Makerere University, P.O Box 22418, Kampala, Uganda.\u003Cbr>2 Division of Infectious Diseases & International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, 55455, USA.\u003Cbr>3Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, UK.\u003Cbr>4Clinical Research Department, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.\u003Cbr>5 Division of Biostatistics & Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA.\u003Cbr>6Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Durban, 4041, South Africa.\u003Cbr>7SAMRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu Natal, Durban, South Africa.\u003Cbr>8 Department of Neurology, Faculty of Medicine, Universitas Padjadjaran / Hasan Sadikin Hospital, Bandung, 40161, Indonesia.\u003Cbr>9 Research Center for Care and Control of Infectious Disease Universitas Padjadjaran, Bandung, 40161, Indonesia.\u003Cbr>This work is licensed under a BY 4.0 International license.\u003Cbr>Correspondence to: Fiona V Cresswell.\u003Cbr>[Corresponding author: Fiona V Cresswell MBChB PhD f.cresswell@bsms.ac.uk](Corresponding author: Fiona V Cresswell MBChB PhD f.cresswell@bsms.ac.uk), Brighton and Sussex Medical School-Global Health and Infection Brighton BN1 9PX, Corresponding Author: Dr. Fiona Cresswell, Infectious Diseases Institute, College of\u003Cbr>Health Sciences, Makerere University. Tel: +256 312 307 000, [f.cresswell@bsms.ac.uk](f.cresswell@bsms.ac.uk). |\n\nEurope PMC unders uthManuscripts Europe M eC und Author Manuscripts  \nMeya et al. Page 2  \n10 Department of Neurology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia.  \n11KwaZulu-Natal Research Innovation and Sequencing Platform, School of Laboratory Medicine & Medical Sciences, University of KwaZulu-Natal, Durban, 4001, South Africa.  \n12 Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia.  \n13 Department of Neurology, Cibabat General Hospital, Cimahi, 40513, Indonesia  \n14 Faculty of Medicine, Bandung Islamic University, Bandung, 40116, Indonesia.  \n15 Department of Neurology, Immanuel Hospital, Bandung, 40233, Indonesia  \n16 Department of Neurology, Bhayangkara TK. I Pusdokkes Polri Hospital, Jakarta, Indonesia  \n17 Department of Pharmacy, Pharmacology and Toxicology, Radboud Institute for ","cbCaivvdfGFg5QOq","https://ap.wps.com/l/cbCaivvdfGFg5QOq","pdf",1511554,"English","# Abstract\n## Background\n## Methods\n## Results","[{\"question\":\"What question did the trial investigate?\",\"answer\":\"Whether intensified higher-dose oral rifampicin improves survival in adults with tuberculous meningitis compared with a matched placebo regimen.\"},{\"question\":\"How was rifampicin dosing implemented in the study?\",\"answer\":\"Participants received standard daily isoniazid, rifampicin, ethambutol, and pyrazinamide plus additional rifampicin (total 35 mg/kg) or matched placebo (total 10 mg/kg) for the first 8 weeks.\"},{\"question\":\"What was the primary endpoint?\",\"answer\":\"Six-month survival.\"}]","Randomized Trial of High Dose Oral Rifampicin in Adult Tuberculous Meningitis | PDF",1790722001]