Chonnam Med J.  2017 May;53(2):103-109. 10.4068/cmj.2017.53.2.103.

Clinical Implications of New Drugs and Regimens for the Treatment of Drug-resistant Tuberculosis

• Kwon YS

• KMID: 2379282
• DOI: http://doi.org/10.4068/cmj.2017.53.2.103

Abstract

The emergence of drug-resistant tuberculosis (TB) is a growing problem worldwide. The lack of safe and effective drugs, together with the frequent development of adverse drug reactions can result in worse outcomes. Therefore, new TB drugs able to bolster the current TB treatment regimen are urgently required. Novel drugs that are effective and safe against Mycobacterium tuberculosis are required to reduce the number of drugs and the duration of treatment in both drug-susceptible TB and multi-drug-resistant (MDR)-TB. This review covers promising novel TB drugs and regimens that are currently under development. Bedaquiline and delamanid are the most promising novel drugs for the treatment of MDR-TB, each having a high efficacy and tolerability. However, the best regimen for achieving better outcomes and reducing adverse drug reactions remains yet to be determined, with safety concerns regarding cardiac events due to QT prolongation still to be addressed. Pretomanid is a novel drug that potentially shortens the duration of treatment in both drug-susceptible and drug-resistant TB. Many regimens consisting of injection free drugs with shorter treatment duration compared to the conventional treatment are now undergoing clinical trials. Therefore a simple and short treatment with higher efficacy, and lesser adverse drug reactions and drug-drug interaction is expected for patients with MDR-TB.

Keyword

Tuberculosis; Tuberculosis, Multidrug-Resistant; Antitubercular Agents; Bedaquiline; OPC-67683

MeSH Terms

Antitubercular Agents
Drug-Related Side Effects and Adverse Reactions
Humans
Mycobacterium tuberculosis
Tuberculosis
Tuberculosis, Multidrug-Resistant*
Antitubercular Agents

Figure

• 

  FIG. 1 New tuberculosis drugs in the current development pipeline. Details for projects and ongoing projects without a lead compound series can be viewed at the Working Group on New TB Drugs (http://www.newtbdrugs.org/). GPL: good laboratory practice, OBR: optimized background regimen.

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