16 July 2015 - Geneva, Switzerland - This week's New England Journal of Medicine published promising data on the efficacy of one of the newly developed anti-TB compounds for extensively drug-resistant tuberculosis (XDR-TB).
The new data released this week showed that XDR-TB patients receiving delamanid in addition to a WHO- recommended optimized background regimen (OBR), had a higher proportion of 2-month sputum culture conversion (SCC) compared to XDR-TB patients receiving placebo plus OBR alone (7/16, 43.8% vs. 1/10, 10%, p=0.0989). As a result, patients had more than 2 times greater likelihood of a successful treatment outcome. Full details on the study and its conclusions can be found here.
The WHO defines XDR-TB as MDR-TB with additional resistance to at least one fluoroquinolone and a second-line injectable. Because of the difficulty in treating XDR-TB and the lack of treatment options available, it is a near death sentence for some patients.
XDR-TB develops from misuse or mismanagement of second-line TB therapies, which severely limits treatment options. So far, more than 100 countries have reported at least one case of this deadly strain. Treatment of such a complicated form of TB can take two years or more, and is characterized by poor outcomes. Of the patients enrolled in treatment in 2011 globally, only 22% completed it successfully.
The WHO recently added delamanid and bedaquiline to its list of essential medicines and partners are quickly working to increase scale-up and treatment with the new compounds. Otsuka, the manufacturer of delamanid, has set a specific goal of "20 by 2020" as just one part of the recently announced "FighTBack Initiative" - a plan to provide delamanid access to 20% of all diagnosed and treated MDR-TB patients in quality management programmes by the year 2020.
"XDR-TB is the scariest form of anti-microbial resistance because it is produced by an airborne and extremely drug-resistant bug," said Dr Lucica Ditiu, Executive Director of the Stop TB Partnership. "Until we have successful treatments available to combat these types of strains, we will never End TB."
"The global TB community must rally together to ensure delamanid is widely and quickly accessible to those in need. This will involve coordinated efforts to ensure health systems have safeguards in place to ensure rational use and monitoring of delamanid. It will also require global coordination to ensure reliable, uninterrupted supplies of delamanid are provided at affordable prices."
More information on delamanid for XDR-TB and an update on the FighTBack initiative will be presented today from 9:00-10:00am EDT on a call hosted by RESIST-TB. To join the call, email: resisttb@gmail.com.