Breakthrough in TB fight?
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Scientists have been energised by the results of a drug trial carried out in South Africa which was found to have killed 99% of patients' TB bacteria.
The new drug combination, known as PaMZ, was found to be effective in killing 99% of patients' tuberculosis bacteria within two weeks and raised the possibility that there may be a way to stem the growing tide of drug-resistant TB. The results were presented at the International Aids Conference in Washington DC and have been published in the respected Lancet medical journal. But the trial's principal investigator, Stellenbosch University's, Dr Andreas Diacon, said he was cautiously optimistic about the results. "We only tested the drug for two weeks and that is not really long enough for any TB treatment to work," he said.
The trial involved 85 patients, 10 of whom were placed on the standard drug regimen for TB. The other 75 patients received different combinations of TB drugs. Fifteen of them were on the PaMZ combination, which includes the novel TB drug candidate PA-824, moxyfloxacin - an established antibiotic not usually used in first-liner TB treatment - and the existing TB drug pyrazinamide.
Diacon said that while the result was "very promising" it still had to be verified through long trials. This would enable the researchers to find out whether the drug is effective over the long term and rule out the possibility that patients might have a relapse.
A follow-up trial, involving 230 patients who will take the drug for a period of eight weeks, is already underway. If it is successful, the drug will move into a longer, third phase trial involving thousands of participants on three continents.
Diacon said the new approach of testing new drugs in combination with others - rather than in isolation - could make it possible to produce a new drug regimen within a few years.
Christo van Niekerk, senior director of clinical development in the Pretoria office of the non-profit TB Alliance, said early projections on the cost of such a combination drug were promising. "It could be 90% cheaper than existing MDR treatments," he said. "For South Africa, with our burden of multidrug resistant TB patients, it will have substantial and significant implications."
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