Tuberculosis future or investigational therapies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mashal Awais, M.D.[2]; Ammu Susheela, M.D. [3] ; Marjan Khan M.B.B.S.[4]


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.

Future investigations

Principles of future investigations

Any future regimen must fulfill the following recommendations: [1]

  • 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

Drug Phase Class
Moxifloxacin Phase III Fluoroquinolone
Linezolid Phase II Oxazolidinone
AZD-5847 Phase II Oxazolidinone
Sutezolid Phase II Oxazolidinone
Clofazimine Phase II Riminophenazine
SQ-109 Phase II Ethylenediamine
PA-824 Phase IIb Nitroimidazole
Delamanid Phase III Nitroimidazole
Bedaquiline Phase III Diarylquinoline
Data provided by WHO[2]

Tuberculosis vaccine development

  • Neonatal BCG vaccination is partially effective at protecting infants and children, especially from the most severe complications of TB disease.[3]
  • BCG is poorly effective at protecting against pulmonary disease in adults, and hence at decreasing Mycobacterium tuberculosis transmission.[3]
  • 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.[3]
  • This new novel vaccine will also provide the best way to counteract accelerating spread of multi-drug resistant tuberculosis.[3]
  • To this date, this new vaccine has not been developed but many TB vaccine candidates are in pipeline.[3]
  • Potential vaccines are either whole-cell vaccines, adjuvanted proteins, and vectored subunit vaccines.[3]
  • 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.[3]
  • The vaccine PPCs are built through a large consensus building process and originate from interactions with different stakeholders.[3]
  • 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.


  1. "Future therapy purposed by WHO".
  2. "Tuberculosis (TB) Future drugs".
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 "WHO | Tuberculosis vaccine development, SYSTEM DO NOT MOVE OR EDIT".

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