Tuberculosis: Development of New Drugs and Treatment Regimens

Abstract

Tuberculosis (TB) still becomes a public health crisis. Drug-resistant TB (DR-TB) becomes a concern as the increasing DR-TB cases in countries with high TB burden. The 2017 World Health Organization (WHO) guideline recommended a combination of TB treatment consisting of 2 months of intensive phase with isoniazid (H), rifampisin (R), pyrazinamid (Z), and ethambutol (E), followed by 4 months of continuation phase with HR daily. WHO has updated DR-TB treatment guidelines several times. In 2016, WHO recommended shorter regimen and individual regimen based on certain conditions. The most updated 2020 WHO guideline recommended the short regimen consisting of all oral drugs as well as changes in the grouping of medicines used in DR-TB regimens in longer/individual regimens. Bedaquiline, delamanid, pretomanid, and sutezolid are new drugs which have been studied for their uses as anti-TB drugs (ATD). Bedaquilin and delamanid, which have passed phase 3 trials, have been approved and recommended by WHO for DR-TB treatment. Repurposed drugs have been used for DR-TB treatment during the time of evaluation of drugs list and regimens for DR-TB treatment. Fluoroquinolones, clofazimine, linezolid, carbapenem, amoxicillin/clavulanic acid are repurposed drugs. TB and DR-TB management will be updated at any time, based on the latest findings in studies, to evaluate and improve the effectiveness of current treatments. Prevention of active TB disease by the treatment of latent TB infection (LTBI) is also a critical component of the end TB strategy by WHO. Therefore, the development of new drugs for the LTBI treatment is also needed.

TNF-α inhibitor administration in psoriatic arthritis patient with latent tuberculosis and cardiovascular disease as an extra articular manifestation

“…21 Until now, there are several choices of latent TB therapy regimens based on several guidelines; and ongoing and planned studies to find the best regimen to prevent progression from latent TB to active TB. 22 Hepatitis B and C viruses were evaluated on this patient, and the results were negative. There was a fibroinfiltrate feature on the left suprahiler on his chest X-ray.…”

Review artikel: Metode Analisis obat Tuberkulosis Dalam Plasma Darah

“…Terapi pengobatan tuberkulosis terus dikembangkan untuk mencapai hasil pengobatan TB yang maksimal. Pengobatan baru terhadap TB dan penggunaan rejimen TB multidrug-resistant (MDR) yang lebih pendek menjadi pengembangan dari terapi tuberkulosis (Soedarsono., 2021;Van Der Werf et al, 2017;World Health Organization (WHO), 2016). Usaha untuk mencegah MDR-TB dan efek samping pengobatan, dapat dilakukan dengan uji monitoring terapeutik dari konsentrasi obat TB di dalam darah (Jang et al, 2016;Tuzimski, Tomasz;Petruczynik, 2020).…”

Drug Repurposing for Tuberculosis

“…Clofazimine is mainly utilised in combination with other drugs in the second-line treatment of drug-resistant TB and has been classified as a Group 5 medicine by the WHO [24]. TBI-166 a new generation analogue of Clofazimine was demonstrated to exhibit superior antimycobacterial activity in comparison to its predecessor as well as reduced skin discoloration and is currently in a Phase 1 clinical trial [25,26].…”