Tuberculosis: Clinical Trials and New Drug Regimens

Yong-Soo Kwon; Byeong-Ho Jeong; Won-Jung Koh

Disclosures

Curr Opin Pulm Med. 2014;20(3):280-286. 

In This Article

Abstract and Introduction

Abstract

Purpose of review: Recent advances in the development of new drugs and regimens provide hope that well tolerated, effective, and shorter-duration treatments for tuberculosis (TB) will become available. This review covers the recent trials of new TB drugs and regimens.

Recent findings: Moxifloxacin and levofloxacin have equally good efficacy and safety in the early phase of treatment of multidrug-resistant TB (MDR-TB), and linezolid has the potential to cure refractory cases of MDR-TB. Bedaquiline and delamanid may be the best drug candidates for enhancing treatment options for MDR-TB. New chemicals, such as sutezolid, AZD5847, PA-824, SQ109, and BTZ043, show potent activity against Mycobacterium tuberculosis. Late-generation fluoroquinolones in combination with the first-line and second-line anti-TB drugs have been used to shorten the treatment duration in drug-susceptible and MDR-TB.

Summary: New drugs and new combination regimens in clinical trials are expected to increase therapeutic efficacy and shorten treatment duration in both drug-susceptible and drug-resistant TB.

Introduction

Tuberculosis (TB) remains a major global health problem, with 8.6 million incident cases and 1.3 million deaths in 2012.[1] The emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) is an increasing global health problem. MDR-TB is widespread, with an estimated 450 000 incident cases and 170 000 deaths in 2012, and XDR-TB was reported in 92 countries in 2012.[1]

Current TB drugs were developed more than 40 years ago. However, curing TB requires long treatment duration and many TB drugs. Moreover, treatment of drug-resistant TB is difficult because less potent and more toxic drugs, as well as a longer treatment duration, are required. The lack of effective treatment could be one of the causes of low treatment success. For example, in 2010, only 48% of MDR-TB patients were successfully treated.[1]

In recent years, several promising TB drugs have been developed, and new regimens that combine these new drugs with existing drugs have been studied with the aim of reducing treatment duration and drug–drug interactions compared with previous regimens.[2] This article presents an update on the new TB drugs in clinical trials and new regimens for TB treatment.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....