Inhaled drug treatment for tuberculosis: Past progress and future prospects

Hickey, Anthony; Durham, Phillip G.; Dharmadhikari, Ashwin; Nardell, Edward A.

doi:10.1016/j.jconrel.2015.11.018

Cited by 69 publications

(53 citation statements)

References 81 publications

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“…Little is known about the early bactericidal activity of inhalation of anti-TB drugs. The first report studying the effect of inhalation of colistin on transmission of TB, however, unfortunately not an EBA study, was presented at the Union conference in Vancouver in 2013 [117,118]. Theoretically, inhalation of a drug can produce high concentrations at the site of infection .…”

Section: Five-year Viewmentioning

confidence: 99%

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

Alffenaar

Akkerman

Anthony

et al. 2016

Expert Review of Anti-infective Therapy

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Introduction: Success rates for treatment of extensively drug resistant tuberculosis (XDR-TB) are low due to limited treatment options, delayed diagnosis and inadequate health care infrastructure. Areas covered: This review analyses existing programmes of prevention, diagnosis and treatment of XDR-TB. Improved diagnostic procedures and rapid molecular tests help to select appropriate drugs and dosages. Drugs dosages can be further tailored to the specific conditions of the patient based on quantitative susceptibility testing of the M. tuberculosis isolate and use of therapeutic drug monitoring. Pharmacovigilance is important for preserving activity of the novel drugs bedaquiline and delamanid. Furthermore, biomarkers of treatment response must be developed and validated to guide therapeutic decisions. Expert commentary: Given the currently poor treatment outcomes and the association of XDR-TB with HIV in endemic regions, a more patient oriented approach regarding diagnostics, drug selection and tailoring and treatment evaluation will improve treatment outcome. The different areas of expertise should be covered by a multidisciplinary team and may involve the transition of patients from hospitalized to home or community-based treatment.

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Section: Five-year Viewmentioning

confidence: 99%

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

Alffenaar

Akkerman

Anthony

et al. 2016

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

show abstract

“…By increasing the level of active pharmaceutical ingredient (API) at the site of action and achieving comparable plasma levels to oral treatment with lower doses an inhaled treatment could facilitate reduced dosage regimens and decreased systemic side effects, thus encouraging compliance. To date, a great deal of research into targeted formulations for the treatment of Mtb infection has been carried out using standard anti-tubercular drugs [194], therefore a novel HDT cargo may provide an ideal synergy of drug and design to get a new treatment to market. …”

Section: Potential Advanced Formulations For Targeted Respiratory Dementioning

confidence: 99%

“…Reformulation of the first-line anti-tubercular agents began some time ago [194,195]. Interest has also arisen in the formulation of second-line TB treatments such as the injectables (Aminoglycosides) for inhalation with the aim of reducing undesirable effects [194].…”

Section: Formulation Experience With Hdt In Clinical and Non-clinicalmentioning

confidence: 99%

“…Interest has also arisen in the formulation of second-line TB treatments such as the injectables (Aminoglycosides) for inhalation with the aim of reducing undesirable effects [194]. Little has been published on HDT inhalation therapy thus far apart from recombinant Interferon-ɣ (IFN-ɣ) administered off label as an adjunctive treatment for TB, as previously mentioned.…”

Section: Formulation Experience With Hdt In Clinical and Non-clinicalmentioning

confidence: 99%

“…One review articles lists numerous combinations that have been tested using standard anti-tubercular drugs in liposomes, microparticles and nanoparticles with the aim to potentially reducing the burden of treatment to the patient [194]. Depending on the physico-chemical characteristics of the HDT to be formulated, there are many choices available some of which will be discussed later.…”

Section: Formulation Experience With Hdt In Clinical and Non-clinicalmentioning

confidence: 99%

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