A new combination of drugs to treat tuberculosis (TB) could offer renewed hope in the fight against the disease, thought to kill around 1.4 million people every year. The results of a phase II trial involving 85 patients show that the new combination could kill more than 99 per cent of patients’ TB bacteria within two weeks, and could lead to improved treatment for patients infected with forms of TB that are resistant to existing drug treatments, as well as those infected with drug-susceptible TB.
Scientists working in Cape Town, South Africa, tested the new combination of drugs, which consists of PA-824 (a new TB drug candidate), moxifloxacin (an established antibiotic currently in development for use as a first-line TB treatment), and an existing TB drug called pyrazinamide, on patients infected with TB. Assessing patients over a period of two weeks, they found that the effectiveness of the new combination was comparable to and could be more effective than the existing standard regimen for treating drug-susceptible TB, with the significant advantage that PaMZ could potentially be used to treat patients infected with drug-resistant forms of TB.
“Treating drug-sensitive and drug-resistant TB with the same regimen can simplify the delivery of TB treatment worldwide”, according to the study’s lead author Dr Andreas Diacon, of Stellenbosch University, Cape Town, South Africa. “The results of this study give healthcare providers on the front lines of the TB epidemic hopes for better, faster tools needed to stop this disease.”
The new combination also has the potential advantage of being usable by TB patients who are also HIV positive and using antiretroviral drugs; many existing treatments cannot be used alongside antiretroviral drugs, which is a huge problem as globally TB is the most common cause of death in people infected with HIV.
The research was presented at the 2012 International AIDS Conference, and was conducted by a team of researchers based at Stellenbosch University, Karl Bremer Hospital, Groote Schuur Hospital and University of Cape Town Lung Institute in Cape Town, South Africa; the University of Otago, Dunedin, New Zealand; the Medical Research Council, Pretoria, South Africa and the non-profit organisation TB Alliance, based in New York, USA and Pretoria, South Africa.
Dr Giovanni Battista Migliori of the WHO Collaborating Centre for Tuberculosis and Lung Diseases, describes the study as making “several important contributions to the existing body of knowledge,” including the promising signs that PaMZ could be used to treat drug-resistant forms of the disease and also those patients using antiretroviral drugs.
However, Dr Migliori also points out that promising new drug regimens such as those described by Dr Diacon and colleagues will need to be used carefully if health care providers are to avoid repeating the mistakes of the past, adding that “The international community has the chance to prevent the misuse of new drugs and regimens. To protect the investment in these drugs, the rational use of antibiotics within strengthened health systems is necessary to avoid the real risk of losing these new agents in a time shorter than that needed to develop them.”
The Lancet
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