New drugs and new regimens for the treatment of tuberculosis: review of the drug development pipeline and implications for national programmes.

PURPOSE OF REVIEW: The aim is to review briefly the problems related to treatment of drug-susceptible and drug-resistant tuberculosis (TB), describe recent advances in the development of new drugs and new regimens, and discuss implications for control programmes.

RECENT FINDINGS: Encouraging advances in TB drug research and development have been made since the turn of the century, resulting in a large number of new products introduced into the global portfolio.

SUMMARY: Currently, nine compounds at least have advanced to clinical development, including four existing drugs redeveloped for TB indication and five new chemical entities. Present clinical trials are testing new combinations of drugs for a shortened treatment of drug-susceptible TB (<6 months duration) or the safety and efficacy of new drugs in addition to an optimized background therapy for the treatment of multidrug-resistant TB. There are at least 34 compounds or projects in the discovery and preclinical stages, including eight compounds in preclinical development. This increasing development of single compounds underscores the needs for a novel approach to test for optimal drug combinations that would be proposed for treatment of TB in all its forms, and the necessary collaboration of pharmaceutical companies, academia, research institutions, donors, and regulatory authorities.