Tuberculosis treatment and management-an update on treatment regimens, trials, new drugs, and adjunct therapies

Alimuddin Zumla, Jeremiah Chakaya, Rosella Centis, Lia D'Ambrosio, Peter Mwaba, Matthew Bates, Nathan Kapata, Thomas Nyirenda, Duncan Chanda, Sayoki Mfinanga, Michael Hoelscher, Markus Maeurer, Giovanni Battista Migliori

Research output: Contribution to journalArticle

Abstract

WHO estimates that 9 million people developed active tuberculosis in 2013 and 1·5 million people died from it. Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis continue to spread worldwide with an estimated 480 000 new cases in 2013. Treatment success rates of MDR and XDR tuberculosis are still low and development of new, more effective tuberculosis drugs and adjunct therapies to improve treatment outcomes are urgently needed. Although standard therapy for drug-sensitive tuberculosis is highly effective, shorter, more effective treatment regimens are needed to reduce the burden of infectious cases. We review the latest WHO guidelines and global recommendations for treatment and management of drug-sensitive and drug-resistant tuberculosis, and provide an update on new drug development, results of several phase 2 and phase 3 tuberculosis treatment trials, and other emerging adjunct therapeutic options for MDR and XDR tuberculosis. The use of fluoroquinolone-containing (moxifloxacin and gatifloxacin) regimens have failed to shorten duration of therapy, and the new tuberculosis drug pipeline is sparse. Scale-up of existing interventions with increased investments into tuberculosis health services, development of new antituberculosis drugs, adjunct therapies and vaccines, coupled with visionary political leadership, are still our best chance to change the unacceptable status quo of the tuberculosis situation worldwide and the growing problem of drug-resistant tuberculosis.

Original languageEnglish
Pages (from-to)220-234
Number of pages15
JournalThe Lancet Respiratory Medicine
Volume3
Issue number3
DOIs
Publication statusPublished - Mar 1 2015

    Fingerprint

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Zumla, A., Chakaya, J., Centis, R., D'Ambrosio, L., Mwaba, P., Bates, M., Kapata, N., Nyirenda, T., Chanda, D., Mfinanga, S., Hoelscher, M., Maeurer, M., & Migliori, G. B. (2015). Tuberculosis treatment and management-an update on treatment regimens, trials, new drugs, and adjunct therapies. The Lancet Respiratory Medicine, 3(3), 220-234. https://doi.org/10.1016/S2213-2600(15)00063-6