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An experimental three-drug
combination to treat tuberculosis shows promise and does not include either of
two standard TB drugs that cause most cases of drug resistance, according to
research reported Monday at the 19th International AIDS Conference. The study
was funded by the Bill & Melinda Gates Foundation and other groups.
Standard TB treatment requires
taking four medications for six months. Cases of multidrug-resistant TB are
largely the result of TB bacteria not responding to two of the standard drugs:
isoniazid and rifampicin. Treating drug-resistant TB can take more than two
years and does not always work.
In the study, scientists in South
Africa divided 85 newly diagnosed TB patients into different groups who got
combinations of standard or experimental TB drugs. Fifteen received a trio of
drugs that included an experimental antibiotic, PA-824, along with the
pneumonia drug moxifloxacin and an older TB drug, pyrazinamide. In a two-week
test, the drug trio worked as well as the standard four-drug therapy and
possibly worked a bit faster, said Dr. Mel Spigelam of the nonprofit TB
Alliance, the Global Alliance for TB Drug Development.
Lead researcher Dr. Andreas Diacon
of South Africa’s Stellenbosch University stressed that these patients were not
cured in two weeks; however, a two-week test is a standard first step in new
drug development. A larger study has begun in South Africa, Tanzania, and
Brazil that will last two months.
If the drug trio bears out its
promise, it could offer a much-needed alternative for multidrug-resistant TB as
well, according to Spigelam. Also, it might be useful for TB patients with
HIV/AIDS who are not tolerating their current TB medications.
The study also showed that testing
novel combinations of drugs - rather than adding drugs onto standard treatment
- might be a way to shorten the drug development process, according to Mario
Raviglione of the World Health Organization.
[PNU editor’s note: The study,
“14-Day Bactericidal Activity of PA-824, Bedaquiline, Pyrazinamide, and
Moxifloxacin Combinations: A Randomized Trial,” was published in the Lancet
(2012;doi:10.1016/S0140-6736(12)61080).]
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