Advancements in Long-Acting TB Treatments: A Promising Future Ahead

Research is underway to develop long-acting tuberculosis (TB) treatments, with the potential to simplify and improve adherence to TB preventive therapy. Current studies are still in the early phases, focusing on the effectiveness of injectable formulations as alternatives to extensive pill regimens. Preliminary surveys show strong interest from both healthcare providers and patients for these innovative treatments, signaling a potentially transformative approach to TB management.

Tuberculosis (TB) treatment and preventive therapy often require extensive pill regimens spanning several months. Researchers are exploring innovative long-acting formulations that could potentially reduce a complete course of TB preventive therapy to a single injection. While there is optimism surrounding these developments, it is important to note that they remain in the early research stages, with pivotal effectiveness studies likely several years away.

In the context of treatment, South Africa recommends TB preventive therapy for all close contacts of individuals diagnosed with the disease. Typically, this therapy involves taking tablets for three to six months, although shorter courses have been shown to enhance completion rates. Transitioning to long-acting injections could streamline treatment processes and significantly improve patient adherence.

Long-acting formulations for TB preventive therapy are seen as more achievable compared to those for TB treatment, which often necessitate the use of multiple drug combinations over extended periods. Current strategies suggest that long-acting medications might effectively replace the continuation phase of treatment, potentially shortening the entire regimen to just two months of tablet intake.

Dr. Eric Nuermberger from Johns Hopkins University emphasized that not all TB medications are suited for long-acting formulations. He indicated three necessary characteristics: low solubility, low clearance rates in the bloodstream, and high potency. One major hurdle in developing long-acting TB therapies is the lack of reliable biomarkers to gauge effectiveness during early trials.

Without solid biomarkers, researchers must progress from preclinical studies to Phase 3 trials, skipping the usual Phase 2 stages necessary to prove efficacy. Nonetheless, the search for biomarkers indicating the risk of developing TB disease remains an essential scientific focus. Nuermberger reported that many product developments are still at the pre-clinical stage, highlighting the complexities in modeling the efficacy of depot drugs.

Fortunately, the landscape for long-acting TB formulations is rapidly expanding. Bedaquiline, a drug currently utilized for treating drug-resistant TB, is undergoing early research for a long-acting injectable form by Janssen in Austria. Several other potential long-acting TB drugs, including rifabutin and rifapentine, are also in examination stages at various research institutions.

Moreover, significant financial support from entities like Unitaid and the Gates Foundation is catalyzing the development of diverse long-acting drug delivery methods, including nanoparticles and in-situ forming implants. These innovations are pivotal in providing effective treatment with reduced frequency of administration.

Survey results presented by Dr. Marcia Vermeulen revealed strong preferences among patients and healthcare providers for long-acting TB treatments. Approximately 75% of healthcare workers stated they would recommend injectable products over pills if uniformly priced or cheaper. There is considerable enthusiasm surrounding the potential benefits of long-acting therapies, particularly among TB survivors, as they may facilitate improved adherence and treatment outcomes.

In summary, the pursuit of long-acting tuberculosis treatments represents a promising frontier in medical innovation, particularly for TB preventive therapy. While significant challenges remain in terms of research and product development, preliminary surveys indicate strong support from both patients and healthcare providers for these novel treatments. Enhanced adherence and improved patient outcomes may transform the landscape of TB therapy in the coming years, pending the successful completion of ongoing research studies. The collective effort of scientists, institutions, and funding partners could pave the way for effective long-acting solutions to combat TB.

Original Source: allafrica.com