Principes de conception de futurs schémas thérapeutiques pour traiter la tuberculose multirésistante

Translated title of the contribution: Principles for designing future regimens for multidrug-resistant tuberculosis

Grania Brigden, Bern Thomas Nyang'wa, Philipp du Cros, Francis Varaine, Jennifer Hughes, Michael Rich, C. Robert Horsburgh, Carole D. Mitnick, Eric Nuermberger, Helen McIlleron, Patrick P J Phillips, Manica Balasegaram

Research output: Contribution to journalArticle

Abstract

Fewer than 20% of patients with multidrug-resistant (MDR) tuberculosis are receiving treatment and there is an urgent need to scale up treatment programmes. One of the biggest barriers to scale-up is the treatment regimen, which is lengthy, complex, ineffective, poorly tolerated and expensive. For the first time in over 50 years, new drugs have been developed specifically to treat tuberculosis, with bedaquiline and potentially delamanid expected to be available soon for treatment of MDR cases. However, if the new drugs are merely added to the current treatment regimen, the new regimen will be at least as lengthy, cumbersome and toxic as the existing one. There is an urgent need for strategy and evidence on how to maximize the potential of the new drugs to improve outcomes and shorten treatment. We devised eight key principles for designing future treatment regimens to ensure that, once they are proven safe in clinical trials, they will be clinically effective and programmatically practicable. Regimens should contain at least one new class of drug; be broadly applicable for use against MDR and extensively drug-resistant Mycobacterium tuberculosis complex strains; contain three to five effective drugs, each from a different drug class; be delivered orally; have a simple dosing schedule; have a good side-effect profile that allows limited monitoring; last a maximum of 6 months; and have minimal interaction with antiretrovirals. Following these principles will maximize the potential of new compounds and help to overcome the clinical and programmatic disadvantages and scale-up constraints that plague the current regimen.

Original languageFrench
Pages (from-to)68-74
Number of pages7
JournalBulletin of the World Health Organization
Volume92
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Multidrug-Resistant Tuberculosis
Pharmaceutical Preparations
bedaquiline
Therapeutics
Extensively Drug-Resistant Tuberculosis
Plague
Poisons
Mycobacterium tuberculosis
Appointments and Schedules
Tuberculosis
Clinical Trials

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine(all)

Cite this

Brigden, G., Nyang'wa, B. T., du Cros, P., Varaine, F., Hughes, J., Rich, M., ... Balasegaram, M. (2014). Principes de conception de futurs schémas thérapeutiques pour traiter la tuberculose multirésistante. Bulletin of the World Health Organization, 92(1), 68-74. https://doi.org/10.2471/BLT.13.122028

Principes de conception de futurs schémas thérapeutiques pour traiter la tuberculose multirésistante. / Brigden, Grania; Nyang'wa, Bern Thomas; du Cros, Philipp; Varaine, Francis; Hughes, Jennifer; Rich, Michael; Horsburgh, C. Robert; Mitnick, Carole D.; Nuermberger, Eric; McIlleron, Helen; Phillips, Patrick P J; Balasegaram, Manica.

In: Bulletin of the World Health Organization, Vol. 92, No. 1, 2014, p. 68-74.

Research output: Contribution to journalArticle

Brigden, G, Nyang'wa, BT, du Cros, P, Varaine, F, Hughes, J, Rich, M, Horsburgh, CR, Mitnick, CD, Nuermberger, E, McIlleron, H, Phillips, PPJ & Balasegaram, M 2014, 'Principes de conception de futurs schémas thérapeutiques pour traiter la tuberculose multirésistante', Bulletin of the World Health Organization, vol. 92, no. 1, pp. 68-74. https://doi.org/10.2471/BLT.13.122028
Brigden, Grania ; Nyang'wa, Bern Thomas ; du Cros, Philipp ; Varaine, Francis ; Hughes, Jennifer ; Rich, Michael ; Horsburgh, C. Robert ; Mitnick, Carole D. ; Nuermberger, Eric ; McIlleron, Helen ; Phillips, Patrick P J ; Balasegaram, Manica. / Principes de conception de futurs schémas thérapeutiques pour traiter la tuberculose multirésistante. In: Bulletin of the World Health Organization. 2014 ; Vol. 92, No. 1. pp. 68-74.
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