Tuberculosis future or investigational therapies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D.  ; Associate Editor(s)-in-Chief: Mashal Awais, M.D.; Ammu Susheela, M.D.  ; Marjan Khan M.B.B.S.
With emergence of new drug-resistant tuberculosis, the role of future therapies is crucial in curbing outbreaks. The new drugs should be more effective than the current regimen and a few drugs in clinical trials have been showing promising results.
Principles of future investigations
Any future regimen must fulfill the following recommendations: 
- It should not have more than a maximum duration of 6 months
- The dosing schedule must be simple
- The ideal number of drugs should not exceed 3-5 drug from a different class
- It should have a minimum side effect profile so that we could have minimum monitoring
- It should be effective against MDR, XDR, and XXDR strains
- It should be administered orally
- It should have minimum interaction with antiretroviral drugs.
- It should have at least one new class of drug
New drugs involved in a clinical trial for the treatment of tuberculosis
|Data provided by WHO|
Tuberculosis vaccine development
- Neonatal BCG vaccination is partially effective at protecting infants and children, especially from the most severe complications of TB disease.
- BCG is poorly effective at protecting against pulmonary disease in adults, and hence at decreasing Mycobacterium tuberculosis transmission.
- A new novel vaccine is needed to reduce the incidence and mortality of tuberculosis; a vaccine that is effective in adult individuals who have not yet been infected with mycobacterium tuberculosis, in addition to in those with latent mycobacterium tuberculosis infection.
- This new novel vaccine will also provide the best way to counteract accelerating spread of multi-drug resistant tuberculosis.
- To this date, this new vaccine has not been developed but many TB vaccine candidates are in pipeline.
- Potential vaccines are either whole-cell vaccines, adjuvanted proteins, and vectored subunit vaccines.
- A document highlighting WHO preferred Product Characteristics (PPC) for new TB vaccines has been devised based on a high unmet medical need and technical feasibility assessment.
- The vaccine PPCs are built through a large consensus building process and originate from interactions with different stakeholders.
- The new vaccine, made by GSK and now known as M72/AS01E, was tested in about 3,300 adults in Kenya, South Africa, and Zambia.
- All of them already had latent tuberculosis, Of those who got two doses of the GSK vaccine, only 13 developed active tuberculosis during three years of follow-up, according to the new study which was published in The New England Journal of Medicine. On the other hand, 26 of those who received a placebo progressed to active tuberculosis.