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A study amongst newly diagnosed multidrug-resistant tuberculosis (MDRTB) patients in hospitals in South Africa has shown that the diarylquinoline TMC207 provides new treatment options for tuberculosis.

Researchers found that the addition of TMC207 to standard therapy for multi-drug resistant tuberculosis in the eight-week trial on hospitalised patients reduced the time required for the conversion of sputum and increased the proportion of patients that converted.

“This is an exciting new development and the first new tuberculosis drug in over forty years,” says Doctor Alexander Pym, one of the researchers and chief specialist scientist from South Africa’s Medical Research Council’s Clinical and Biomedical TB Research Unit based in Durban, South Africa.

Forty-one out of 47 recruited MDRTB patients completed the eight-week course, combing TMC207 (described by Pym as a new class of antibiotics) with the standard five-drug second-line regimen.

The results from the first phase of a randomised, phase-2, placebo-controlled trial, recently published in the New England Journal of Medicine, showed a significant increase in sputum conversion of 48 percent in the TMC207 patients compared to 4 percent of the placebo patients and that TMC207 inhibits mycobacterial ATP synthase.

“This study tested the first new anti-tuberculosis drug in 40 years on people with MDRTB, and after two months almost 50 percent of patients taking the new drug in combination with the standard drugs for MDRTB showed their sputum no longer contained TB, versus less than 10 percent of the placebo group,” says Pym.

Although further studies are needed, the researchers expect TMC207 could reduce the extensive period that tuberculosis patients need to take anti-tuberculosis drugs.

“This is the first time in 40 years that something looks promising. What we saw over the eight weeks was a significant difference in the rate in which tuberculosis disappeared,” Professor Andreas Diacon, one of the researchers and Director, Centre of Clinical Tuberculosis Research at the University of Stellenbosch told SciDev.Net.

In the laboratory the drug works on all kinds of tuberculosis and the implications are that this new drug might shorten treatment for all tuberculosis patients says Daicon.

MDRTB patients are currently required to take five drugs for up to 18 months, and patients with non-resistant tuberculosis take four drugs for six months.

The fact that the this is a new drug to which patients have not developed a resistance will also increase the portion of people who could be cured says Daicon.

He added that TCM207 had attracted some attention as it was discovered using methods that are currently considered unconventional. The modern approach is to use computer software to identify target cells and design drugs to have the desired effect, but the discovery of TCM207 used old methods that had not been exploited over the last 40 years.

The trials are ongoing and now that there is sufficient safety data on TMC207 a second group of MDRTB patients is currently undergoing a six-month trial using TCM207 in combination with the five-drug regimen for MDRTB.

 

This article was publlished by SciDev.Net