South Africa: Anticipation Grows for Long-Acting Tuberculosis Treatments

Excitement is growing for long-acting tuberculosis (TB) therapies that could simplify treatment regimens. Current research seeks to replace multiple pills with single injections. Although advances have been made in injectable anti-HIV treatments, TB research is still emerging. Challenges include developing effective formulations and reliable biomarkers for assessment. However, preferences from both patients and providers suggest strong support for injectable TB treatments.

In South Africa, excitement surrounds the potential for long-acting tuberculosis (TB) treatments that could drastically reduce pill regimens. These innovative therapies aim to evolve TB preventive care from multi-month tablet courses to a single injection. While successful long-acting formulations have revolutionized HIV treatment, TB research remains in its infancy, with pivotal study results still a few years away, despite promising developments.

Currently, TB preventive therapy requires taking numerous tablets for extended periods. In South Africa, it is advised for those closely connected to individuals suffering from TB. Research indicates that shorter regimens enhance treatment completion rates, with a focus on single-injection solutions being a promising alternative. The simplicity of long-acting formulations for preventive therapy, often involving just one or two drugs, offers a favorable target compared to the more complex TB treatment regimens.

The treatment of active TB spans six or more months and necessitates multiple drugs. The possibility of transitioning to long-acting treatments earlier in the regimen protocol could further streamline care and adherence. However, success is contingent upon developing formulations that meet specific drug-related criteria, as explained by Dr. Eric Nuermberger from Johns Hopkins University, who highlighted the unique challenges unique to TB drugs and the need for suitable biomarkers

Nuermberger indicated that a significant hurdle is the lack of reliable biomarkers for gauging the efficacy of long-acting TB therapies in early-stage trials. The absence of quantifiable bacteria during latent TB infection complicates the process. Instead of the usual methodologies, the field must leap from preclinical studies to large-scale phase 3 trials.

Despite these obstacles, there has been noticeable progress in long-acting TB formulations, with increased development in recent years. Currently, long-acting injectable bedaquiline is the most advanced in trials, with ongoing phase I studies in Austria assessing its safety. Other potential long-acting medications, such as rifabutin and rifapentine, as well as the second-generation diarylquinolines being developed by TB Alliance, are also in the pipeline.

Preclinical research efforts involve various institutions, including universities and pharmaceuticals, enabling diverse approaches such as aqueous nanoparticle suspensions and implants. Patients and healthcare professionals weighed in at recent conferences and showed strong preference for long-acting injectable medications, indicating a potential shift in treatment dynamics.

The interest in long-acting tuberculosis treatments underscores a significant shift in addressing the challenges associated with traditional pill regimens. With promising developments underway, particularly towards injectable solutions that enhance adherence and reduce healthcare burdens, there is hope for improved patient outcomes. However, obstacles remain, especially in establishing effective methodologies for trial assessments and drug efficacy measurements. Engagement of the community in rollout strategies could ensure these advances benefit those most affected by TB.

Original Source: allafrica.com