Experimental drug five times more effective against MDR-TB than conventional therapy

A Johnson & Johnson-run study found that its experimental drug TMC207 could make conventional tuberculosis treatment five times more effective against multi-drug resistant TB (MDR-TB) because it cleared traces of the TB bacteria in the sputum of 48 percent of study volunteers after eight weeks, Reuters reports (Emery, Reuters, 6/3). The results were published on Wednesday in the New England Journal of Medicine.

TMC207 was tested in a Phase 2 trial of 47 South African patients with newly diagnosed MDR-TB, the Dow Jones Newswires/Wall Street Journal reports. "About half received TMC207 and the rest received a fake drug for about eight weeks; all patients took a standard regimen of five existing TB drugs. A higher proportion of patients who received TMC207 tested negative for TB in lung-fluid cultures at eight weeks than the placebo, 48 percent versus 9 percent," the Dow Jones Newswires/Wall Street Journal reports (Loftus, Dow Jones Newswires/Wall Street Journal, 6/3).

According to Reuters, TMC207 is "being billed as the first new TB drug in 40 years." David McNeeley of Tibotec Inc., the subsidiary of Johnson & Johnson that developed the drug, said that TMC207 differs from other TB drugs because it "starves" the bacteria. "It's like cutting off your food supply," he said (Reuters, 6/3). 

In a related NEJM editorial, Clifton Barry of the National Institute of Allergy and Infectious Diseases, writes that the development of TMC207 "represents an important advance in the chemotherapy of TB" and outlines three reasons why. According to Barry, "It is also a humbling case study that is worth some reflection," for those in the "tuberculosis field [who] turned up our noses at looking for compounds that killed anything less than the real human pathogen" (Barry, NEJM, 6/4). 

NEJM published a second study that "describes an international effort to detect" TB in immigrants and refugees that come to the U.S., HealthDay News/Forbes reports. "The TB rate in [foreign-born individuals] is 9.8 times higher than among U.S.-born individuals – 20.6 cases per 100,000 people versus 2.1 per 100,000 people for the native-born. Nearly 58 percent of the new TB cases in the United States in 2007 were diagnosed in the foreign-born group," according to HealthDay News/Forbes (HealthDay News/Forbes, 6/3).