New and Repurposed Drugs for the Treatment of Active Tuberculosis: An Update for Clinicians

Respiration. 2023;102(2):83-100. doi: 10.1159/000528274. Epub 2022 Dec 14.

Abstract

Although tuberculosis (TB) is preventable and curable, the lengthy treatment (generally 6 months), poor patient adherence, high inter-individual variability in pharmacokinetics (PK), emergence of drug resistance, presence of comorbidities, and adverse drug reactions complicate TB therapy and drive the need for new drugs and/or regimens. Hence, new compounds are being developed, available drugs are repurposed, and the dosing of existing drugs is optimized, resulting in the largest drug development portfolio in TB history. This review highlights a selection of clinically available drug candidates that could be part of future TB regimens, including bedaquiline, delamanid, pretomanid, linezolid, clofazimine, optimized (high dose) rifampicin, rifapentine, and para-aminosalicylic acid. The review covers drug development history, preclinical data, PK, and current clinical development.

Keywords: Drugs; Treatment; Tuberculosis.

Publication types

  • Review

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Humans
  • Linezolid / therapeutic use
  • Tuberculosis* / drug therapy
  • Tuberculosis, Multidrug-Resistant* / drug therapy

Substances

  • Antitubercular Agents
  • Linezolid

Grants and funding

This research did not receive grants from any funding agency in the public, commercial, or not-for-profit sectors.