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AFRICA: New Drugs To Speed TB Treatment

Tinus de Jager

JOHANNESBURG*, Nov 15 2010 (IPS) - Researchers are testing a new combination of tuberculosis drugs on patients in South Africa which they are hoping will shorten the treatment term of the disease to six months.

Examining a patient with drug-resistant TB. Credit:  Dominic Chavez/IPS

Examining a patient with drug-resistant TB. Credit: Dominic Chavez/IPS

“I think I have lost my job, you know,” says commuter taxi driver Paul Kyazze “We are not like those office people, [we] have to be at work every day. Now I am here.”

Kyazze is a TB patient at Uganda’s Mulago National Referral Hospital, and worried that he has been asked to stay in the hospital for two months.

“The doctor told me I will get 60 injections – one every day. And I have to be here for all that time, because the injection is administered early in the morning at 6:00 am,” he says.

Treatment will continue long after he’s released. Dr Okot Nuwagara, a TB specialist at Mulago, says the lengthy course of drugs can be difficult for patients.

“There many cases of patients missing their dose and that complicates the treatment. In fact they have to start the treatment afresh,” says the doctor, who has been handling TB cases for 14 years.

The Global Alliance for TB Drug Development says the new drug combination has already shown promise in individual tests, and could reduce the duration of TB treatment sharply.

The trial will take place in South Africa, at the Lung Institute at the University of Cape Town and the TASK Research Centre in Bellville. Sixty-eight patients will each receive two weeks of treatment and three months of follow-up to evaluate effectiveness, safety, and tolerability. After the results of this first phase are analysed, researchers will extend the test for longer exposure to the drugs.

The combination shows promise to treat both drug-sensitive (DS-TB) and multidrug-resistant TB (MDR-TB). The current treatment of MDR-TB patients requires daily injections and drugs for a period of up to 24 months.

The Phase II trial called NC001 or New Combination 1, tests the new TB drug candidates PA-824 and moxifloxacin in combination with pyrazinamide, an existing antibiotic already commonly used in TB treatment.

No conflict with HIV treatment

Dr Andreas Diacon, the co-ordinator of the trials, says HIV is a big factor in TB as well. “None of these drugs have properties that might interfere with the HIV drugs … this is an especially good reason to test these new drugs, as some of the old drugs that were used did interfere with the treatment of HIV.”

Diacon also says researchers are planning to test other combinations of drugs, which could shorten the current testing processes substantially.

“At the moment we are trying to design new trials where new drugs are taken in new combinations from the start, which could shorten the time-span in which new drugs become available. Especially in South Africa we cannot wait for 20 years to have results.”

The South African government has welcomed the research, saying that a successful trial will benefit the world in the fight against TB.

“The development is also more important for us [South Africa] because of the high burden of TB,” said department spokesperson Fidel Hadebe.

The World Health Organization’s Stop TB Department Managing Director, Mario Raviglione, says there is a desperate need for new and better TB treatments to address today’s growing pandemic, which kills nearly two million people each year.

“It is extremely encouraging to see a growing pipeline of TB drug candidates that may revolutionize TB care and committed sponsors moving with speed and efficiency towards new regimens.”

The result of the trials are expected in the next three to four months.

*Joshua Kyalimpa in Kampala contributed to this report.

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