Recent advances in the treatment of tuberculosis
Copyright © 2023 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Tuberculosis (TB) is a global health challenge and one of the leading causes of death worldwide. In the last decade, the TB treatment landscape has dramatically changed. After long years of stagnation, new compounds entered the market (bedaquiline, delamanid, and pretomanid) and phase III clinical trials have shown promising results towards shortening duration of treatment for both drug-susceptible (Study 31/A5349, TRUNCATE-TB, and SHINE) and drug-resistant TB (STREAM, NiX-TB, ZeNix, and TB-PRACTECAL). Dose optimization of rifamycins and repurposed drugs has also brought hopes of further development of safe and effective regimens. Consequently, international and WHO clinical guidelines have been updated multiple times in the last years to keep pace with these advances.
OBJECTIVES: This narrative review aims to summarize the state-of-the-art on treatment of drug-susceptible and drug-resistant TB, as well as recent trial results and an overview of ongoing clinical trials.
SOURCES: A non-systematic literature review was conducted in PubMed and MEDLINE, focusing on the treatment of TB. Ongoing clinical trials were listed according to the authors' knowledge and completed consulting clinicaltrials.gov and other publicly available websites (www.resisttb.org/clinical-trials-progress-report, www.newtbdrugs.org/pipeline/trials).
CONTENT: This review summarizes the recent, major changes in the landscape for drug-susceptible and drug-resistant treatment, with a specific focus on their potential impact on patient outcomes and programmatic TB management. Moreover, insights in host-directed therapies, and advances in pharmacokinetics and pharmacogenomics are discussed. A thorough outline of ongoing therapeutic clinical trials is presented, highlighting different approaches and goals in current TB clinical research.
IMPLICATIONS: Future research should be directed to individualize regimens and protect these recent breakthroughs by preventing and identifying the selection of drug resistance and providing widespread, affordable, patient-centred access to new treatment options for all people affected by TB.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases - (2023) vom: 22. Juli |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Motta, Ilaria [VerfasserIn] |
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| Links: |
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| Themen: |
Clinical trial |
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| Anmerkungen: |
Date Revised 19.08.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.cmi.2023.07.013 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Copyright © 2023 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Tuberculosis (TB) is a global health challenge and one of the leading causes of death worldwide. In the last decade, the TB treatment landscape has dramatically changed. After long years of stagnation, new compounds entered the market (bedaquiline, delamanid, and pretomanid) and phase III clinical trials have shown promising results towards shortening duration of treatment for both drug-susceptible (Study 31/A5349, TRUNCATE-TB, and SHINE) and drug-resistant TB (STREAM, NiX-TB, ZeNix, and TB-PRACTECAL). Dose optimization of rifamycins and repurposed drugs has also brought hopes of further development of safe and effective regimens. Consequently, international and WHO clinical guidelines have been updated multiple times in the last years to keep pace with these advances | ||
| 520 | |a OBJECTIVES: This narrative review aims to summarize the state-of-the-art on treatment of drug-susceptible and drug-resistant TB, as well as recent trial results and an overview of ongoing clinical trials | ||
| 520 | |a SOURCES: A non-systematic literature review was conducted in PubMed and MEDLINE, focusing on the treatment of TB. Ongoing clinical trials were listed according to the authors' knowledge and completed consulting clinicaltrials.gov and other publicly available websites (www.resisttb.org/clinical-trials-progress-report, www.newtbdrugs.org/pipeline/trials) | ||
| 520 | |a CONTENT: This review summarizes the recent, major changes in the landscape for drug-susceptible and drug-resistant treatment, with a specific focus on their potential impact on patient outcomes and programmatic TB management. Moreover, insights in host-directed therapies, and advances in pharmacokinetics and pharmacogenomics are discussed. A thorough outline of ongoing therapeutic clinical trials is presented, highlighting different approaches and goals in current TB clinical research | ||
| 520 | |a IMPLICATIONS: Future research should be directed to individualize regimens and protect these recent breakthroughs by preventing and identifying the selection of drug resistance and providing widespread, affordable, patient-centred access to new treatment options for all people affected by TB | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Clinical trial | |
| 650 | 4 | |a Directed therapy | |
| 650 | 4 | |a Dose | |
| 650 | 4 | |a Host | |
| 650 | 4 | |a Isoniazid resistance | |
| 650 | 4 | |a MDR-TB | |
| 650 | 4 | |a Mycobacterium tuberculosis | |
| 650 | 4 | |a New drugs | |
| 650 | 4 | |a Optimization | |
| 650 | 4 | |a Pharmacogenomics | |
| 650 | 4 | |a Pharmacokinetics | |
| 650 | 4 | |a Pre-XDR TB | |
| 700 | 1 | |a Boeree, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Chesov, Dumitru |e verfasserin |4 aut | |
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| 700 | 1 | |a Lienhardt, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a McIlleron, Helen M |e verfasserin |4 aut | |
| 700 | 1 | |a Paton, Nicholas I |e verfasserin |4 aut | |
| 700 | 1 | |a Stagg, Helen R |e verfasserin |4 aut | |
| 700 | 1 | |a Thwaites, Guy |e verfasserin |4 aut | |
| 700 | 1 | |a Udwadia, Zarir |e verfasserin |4 aut | |
| 700 | 1 | |a Van Crevel, Reinout |e verfasserin |4 aut | |
| 700 | 1 | |a Velásquez, Gustavo E |e verfasserin |4 aut | |
| 700 | 1 | |a Wilkinson, Robert J |e verfasserin |4 aut | |
| 700 | 1 | |a Guglielmetti, Lorenzo |e verfasserin |4 aut | |
| 700 | 0 | |a Study group on Mycobacteria (ESGMYC) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) |e verfasserin |4 aut | |
| 700 | 1 | |a Motta, Ilaria |e investigator |4 oth | |
| 700 | 1 | |a Kherabi, Yousra |e investigator |4 oth | |
| 700 | 1 | |a Van Crevel, Reinout |e investigator |4 oth | |
| 700 | 1 | |a Guglielmetti, Lorenzo |e investigator |4 oth | |
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