Sterilizing activity of novel TMC207- and PA-824-containing regimens in a murine model of tuberculosis

Antimicrob Agents Chemother. 2011 Dec;55(12):5485-92. doi: 10.1128/AAC.05293-11. Epub 2011 Sep 19.

Abstract

To truly transform the landscape of tuberculosis treatment, novel regimens containing at least 2 new drugs are needed to simplify the treatment of both drug-susceptible and drug-resistant forms of tuberculosis. As part of an ongoing effort to evaluate novel drug combinations for treatment-shortening potential in a murine model, we performed two long-term, relapse-based experiments. In the first experiment, TMC207 plus pyrazinamide, alone or in combination with any third drug, proved superior to the first-line regimen including rifampin, pyrazinamide, and isoniazid. On the basis of CFU counts at 1 month, clofazimine proved to be the best third drug combined with TMC207 and pyrazinamide, whereas the addition of PA-824 was modestly antagonistic. Relapse results were inconclusive due to the low rate of relapse in all test groups. In the second experiment evaluating 3-drug combinations composed of TMC207, pyrazinamide, PA-824, moxifloxacin, and rifapentine, TMC207 plus pyrazinamide plus either rifapentine or moxifloxacin was the most effective, curing 100% and 67% of the mice treated, respectively, in 2 months of treatment. Four months of the first-line regimen did not cure any mice, whereas the combination of TMC207, PA-824, and moxifloxacin cured 50% of the mice treated. The results reveal new building blocks for novel regimens with the potential to shorten the duration of treatment for both drug-susceptible and drug-resistant tuberculosis, including the combination of TMC207, pyrazinamide, PA-824, and a potent fluoroquinolone.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibiotics, Antitubercular / administration & dosage
  • Antibiotics, Antitubercular / pharmacology
  • Antibiotics, Antitubercular / therapeutic use*
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use*
  • Colony Count, Microbial
  • Diarylquinolines
  • Disease Models, Animal
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Mice
  • Mice, Inbred BALB C
  • Mycobacterium tuberculosis / drug effects*
  • Nitroimidazoles / administration & dosage
  • Nitroimidazoles / pharmacology
  • Nitroimidazoles / therapeutic use*
  • Quinolines / administration & dosage
  • Quinolines / pharmacology
  • Quinolines / therapeutic use*
  • Secondary Prevention
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / microbiology
  • Tuberculosis, Pulmonary / drug therapy*
  • Tuberculosis, Pulmonary / microbiology

Substances

  • Antibiotics, Antitubercular
  • Antitubercular Agents
  • Diarylquinolines
  • Nitroimidazoles
  • Quinolines
  • pretomanid
  • bedaquiline