Drug Targets Multidrug-Resistant Tuberculosis
Related study shows effectiveness of overseas tuberculosis screening and follow-up
WEDNESDAY, June 3 (HealthDay News) -- When combined with standard tuberculosis treatment, a new drug is effective against multidrug-resistant tuberculosis, according to a study in the June 4 issue of the New England Journal of Medicine. In a related study in the same issue, overseas tuberculosis screening and follow-up after arrival is effective in identifying tuberculosis among immigrants and refugees bound for the United States.
In the first study, Andreas H. Diacon, M.D., from the University of Stellenbosch in Tygerberg, South Africa, and colleagues randomly assigned 47 patients with newly diagnosed multidrug-resistant pulmonary tuberculosis to TMC207 or placebo in addition to a standard five-drug second line antituberculosis treatment. They found that the addition of TMC207 increased the percentage of patients with conversion of sputum cultures from positive to negative (48 versus 9 percent) and reduced the time to conversion (hazard ratio, 11.8).
In the second study, Yecai Liu, from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues analyzed data from tuberculosis screening performed overseas and follow-up data after arrival in the United States among immigrants and refugees from 1999 to 2005. They found that among immigrants, 961 per 100,000 had smear-negative tuberculosis and 837 per 100,000 had inactive tuberculosis. Among refugees, 1,036 per 100,000 had smear-negative tuberculosis and 2,838 per 100,000 had inactive tuberculosis. After arrival in the United States, active pulmonary tuberculosis was diagnosed in 7 percent of individuals with smear-negative tuberculosis and 1.6 percent of individuals with inactive tuberculosis.
"The development of TMC207 represents an important advance in the chemotherapy of tuberculosis," Clifton E. Barry III, Ph.D., from the National Institute of Allergy and Infectious Diseases in Bethesda, Md., writes in an accompanying editorial. "This experience shows that there is always a chance of discovering a new class of molecules, a new therapeutically useful target, and of adopting a new trial design that shows convincing efficacy with the involvement of only 47 patients."
Tibotec BVBA sponsored the study. Several authors of the first study are employees of Tibotec, a Johnson & Johnson company, which developed TMC207.