Repurposing drugs for treatment of tuberculosis: a role for non-steroidal anti-inflammatory drugs

Br Med Bull. 2016 Jun;118(1):138-48. doi: 10.1093/bmb/ldw019. Epub 2016 May 5.

Abstract

Introduction: The number of cases of drug-resistant Mycobacterium tuberculosis, the causative agent of tuberculosis (TB), has risen rapidly in recent years. This has led to the resurgence in repurposing existing drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs), for anti-TB treatment.

Sources of data: Evidence from novel drug screening in vitro, in vivo, pharmacokinetic/pharmacodynamics analyses and clinical trials has been used for the preparation of this systematic review of the potential of NSAIDs for use as an adjunct in new TB chemotherapies.

Areas of agreement: Certain NSAIDs have demonstrated inhibitory properties towards actively replicating, dormant and drug-resistant clinical isolates of M. tuberculosis cells.

Areas of controversy: NSAIDs are a diverse class of drugs, which have reported off-target activities, and their endogenous antimicrobial mechanism(s) of action is still unclear.

Growing points: It is essential that clinical trials of NSAIDs continue, in order to assess their suitability for addition to the current TB treatment regimen. Repurposing molecules such as NSAIDs is a vital, low-risk strategy to combat the trend of rapidly increasing antibiotic resistance.

Keywords: Mycobacterium; NSAIDs; antimicrobial resistance; carprofen; drug repurposing; tuberculosis.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anti-Infective Agents* / pharmacokinetics
  • Anti-Infective Agents* / pharmacology
  • Anti-Infective Agents* / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal* / pharmacokinetics
  • Anti-Inflammatory Agents, Non-Steroidal* / pharmacology
  • Anti-Inflammatory Agents, Non-Steroidal* / therapeutic use
  • Antitubercular Agents / therapeutic use
  • Drug Repositioning*
  • Humans
  • Mycobacterium tuberculosis / drug effects*
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*

Substances

  • Anti-Infective Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antitubercular Agents