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Approval of a tuberculosis drug based on a paradoxical surrogate measure

Jerry Avorn, MD
March 7, 2013, 2:38 p.m.

On December 31, 2012, the US Food and Drug Administration (FDA) announced its approval of a new drug to treat multidrug-resistant tuberculosis (MDR-TB). The agency granted bedaquiline (Sirturo) “fast-track” approval, assessing its efficacy by a surrogate measure rather than an actual clinical outcome. The criterion was the capacity of the drug, compared with placebo, to convert a patient's sputum culture from positive to negative for Mycobacterium tuberculosis when added to a standard MDR-TB regimen.

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Source: JAMA