June 8, 2012

New Hope For TB Patients?

(Ivanhoe Newswire) -- In 2010 the World Health Organization (WHO) estimated there were 290,000 cases of multi-drug resistant tuberculosis globally. Now a new medication attempts to slash those numbers.

Delamanid, a nitro-dihydro-imidazooxazole derivative, is a new medication that inhibits mycolic acid synthesis (long fatty acids found in the cell walls of the mycolata taxon) and has shown potent in vitro (half living-in a Petri dish) and in vivo (living in the body) activity against drug resistant strains of mycobacterium tuberculosis.
A randomized, placebo-controlled, multinational clinical trial was executed. In this trial, 481 patients (nearly all of whom were negative for the human immunodeficiency virus) were assigned different dosages of delamanid. 161 patients were given a dose of 100mg twice daily, 160 patients were given a dose of 200mg twice daily, and 160 patients were given a placebo. This was done for two months in combination with a background drug regimen, developed according to World Health Organization guidelines.

Sputum-cultures were assessed weekly with the use of both liquid broth and solid medium; sputum-culture conversion was defined as a series of five or more consecutive cultures that were negative for growth of mycobacterium tuberculosis.

Among patients who received the background drug regimen plus 100mg of delamanid twice daily, 45.4% had sputum-culture conversion in liquid broth at 2 months, as compared with 29.6% of patients who received a background drug regimen plus the placebo. The group that received the background drug regimen plus 200mg of delamanid twice daily also had a high proportion (41.9%) of patients with sputum-culture conversion. The findings were similar with assessment of sputum-culture conversion in solid medium.

These findings suggest that delamanid could enhance treatment options for multi-drug resistant tuberculosis and bring hope to those suffering.

Source: New England Journal of Medicine, June 2012 and World Health Organization