New developments in the treatment of drug-resistant tuberculosis: clinical utility of bedaquiline and delamanid
As countries improve and scale up their diagnostic services, increasing number of patients with multidrug-resistant TB and extensively drug-resistant TB are identified. Bedaquiline and delamanid offer a real opportunity to improve the outcomes of these patients. After so many decades without new TB drugs the development of these two new medicines is an historic opportunity to gain ground in the fight against TB.
Abstract
The current treatment for
drug-resistant tuberculosis (TB) is long, complex, and
associated with severe and life-threatening side effects and
poor outcomes. For the first time in nearly 50 years, there have
been two new drugs registered for use in multidrug-resistant TB
(MDR-TB). Bedaquiline, a diarylquinoline, and delamanid, a
nitromidoxazole, have received conditional stringent regulatory
approval and have World Health Organization interim policy
guidance for their use.
As countries improve and
scale up their diagnostic services, increasing number of
patients with MDR-TB and extensively drug-resistant TB are
identified. These two new drugs offer a real opportunity to
improve the outcomes of these patients.
This article
reviews the evidence for these two new drugs and discusses the
clinical questions raised as they are used outside clinical
trial settings. It also reviews the importance of the
accompanying drugs used with these new drugs. It is important
that barriers hindering the use of these two new drugs are
addressed and that the existing clinical experience in using
these drugs is shared, such that their routine-use programmatic
conditions is scaled up, ensuring maximum benefit for patients
and countries battling the MDR-TB crisis.
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Source:
Dove Medical Press
