Emerging drugs and alternative possibilities in the treatment of tuberculosis

Abstract

Introduction: Tuberculosis (TB) remains a global health problem. Drug resistance, treatment duration, complexity, and adverse drug reactions associated with anti-TB regimens are associated with treatment failure, prolonged infectiousness and relapse. With the current set of anti-TB drugs the goal to end TB has not been met. New drugs and new treatment regimens are needed to eradicate TB. Areas covered: Literature was explored to select publications on drugs currently in phase II and phase III trials. These include new chemical entities, immunotherapy, established drugs in new treatment regimens and vaccines for the prophylaxis of TB. Expert opinion: Well designed trials, with detailed pharmacokinetic/pharmacodynamic analysis, in which information on drug exposure and drug susceptibility of the entire anti-TB regimen is included, in combination with long-term follow-up will provide relevant data to optimize TB treatment. The new multi arm multistage trial design could be used to test new combinations of compounds, immunotherapy and therapeutic vaccines. This new approach will both reduce the number of patients exposed to inferior treatment and the financial burden. Moreover, it will speed up drug evaluation. Considering the investments involved in development of new drugs it is worthwhile to thoroughly investigate existing, non-TB drugs in new regimens.

Individualizing management of extensively drug-resistant tuberculosis: diagnostics, treatment, and biomarkers

“…A novel approach to try to improve TB treatment outcome is to use therapeutic vaccines [119]. These vaccines modulate the immune system to help it target persisting and dormant TB bacilli thereby improving the sterilizing capacity of the human immune system [120].…”

Impact of Hypoxia on Drug Resistance and Growth Characteristics of Mycobacterium tuberculosis Clinical Isolates

“…However, despite therapy based on the test results, there are still some cases of treatment failure [14]. We speculate that one of the causes for this may be related to changes in MTB resistance under hypoxia.…”

Comparison of Adequacy of Dialysis between Single-use and Reused Hemodialyzers in Patients on Maintenance Hemodialysis

“…It is estimated that 9.7% of MDR-TB cases develop XDR-TB, which is actually more worrisome. 18,19 Success rate in XDR-TB treatment is significantly low. Treatment failure not only leads to transmission of infection but also leads to chronic lung disease.…”