Grantham Hospital, Tuberculosis and Chest Unit, 125 Wong Chuk Hang Road, Hong Kong, China.
Expert Opin Emerg Drugs. 2011 Mar;16(1):1-21. doi: 10.1517/14728214.2011.521497. Epub 2010 Sep 26.
The tuberculosis epidemic continues in much of the developing world fueled by the concurrent HIV epidemic. Due to the emergence of multidrug and extensively drug-resistant isolates of tuberculosis, there is a critical need for new drug regimens for the treatment of this disease. Currently, five new compound classes are in various stages of clinical development for tuberculosis.
Selected literature from the past 5 years was reviewed and the current status of compounds in preclinical development and those compounds undergoing clinical studies in humans is described in detail as well as their known potential limitations. After a > 40-year period of almost no effort to discover and develop new therapeutics for tuberculosis, there are now significant activities by small and large pharmaceutical companies in this area. The reader will understand the current status of agents undergoing clinical evaluation for tuberculosis.
The challenge in antituberculosis drug development is to make available to patients highly effective regimens which present substantial barriers to resistance development in an affordable formulation. Shortening the length of therapy from the current 6 to 3 months or less is a goal for the newly developed regimens. For the first time in many years, there are bright prospects for improving regimens for the therapy of tuberculosis.
在许多发展中国家,结核病流行仍在继续,这是由同时发生的艾滋病毒流行所推动的。由于出现了耐多药和广泛耐药的结核分枝杆菌分离株,因此迫切需要新的药物方案来治疗这种疾病。目前,有五种新的化合物类别处于不同的临床开发阶段,用于结核病。
对过去 5 年的选定文献进行了回顾,并详细描述了处于临床前开发阶段的化合物和正在进行人体临床研究的化合物的现状,以及它们已知的潜在局限性。在经过 40 多年几乎没有努力发现和开发结核病新疗法之后,现在许多大小制药公司都在这一领域开展了大量活动。读者将了解正在进行临床评估的抗结核药物的现状。
抗结核药物开发的挑战是为患者提供高效的治疗方案,这种方案以负担得起的制剂形式对耐药性的产生构成实质性障碍。将目前的 6 个月疗程缩短至 3 个月或更短是新开发方案的目标。多年来,首次有了改善结核病治疗方案的光明前景。