Scientists discover how to treat very multi-drug resistant tuberculosis with high mortality with a few drugs


by qimono

Many people who live in Japan are not so familiar with the disease “ tuberculosis ”, and it may be perceived that it is an infectious disease that was common to old people at best. But still in the world, tuberculosis is a terrible infection that put the number of dead as more than AIDS, in recent years with a resistance to antibiotics used in the treatment of tuberculosis, multidrug-resistant tuberculosis (MDR-TB) and super multi-agent Resistant tuberculosis (XDR-TB) is prominent. It is reported that scientists have discovered a new treatment for such multi-drug resistant tuberculosis.

Scientists Discover New Cure for the Deadliest Strain of Tuberculosis-The New York Times
https://www.nytimes.com/2019/08/14/health/tuberculosis-xdr-tb-cure.html

The number of people infected with tuberculosis reaches 10 million people every year worldwide, and multidrug-resistant tuberculosis and super-drug-resistant tuberculosis, which are difficult for antibiotics, have a high fatality rate. It seems that only a few of all TB patients are infected with super-drug-resistant tuberculosis, but more than 30,000 cases have been confirmed in more than 100 countries. In addition, since medical workers think that `` many patients with multi-drug resistant tuberculosis died before receiving medical care '', there may actually be more infected people than the numbers about. If you are infected with super multi-drug resistant tuberculosis, the survival rate is about 34% even if you receive treatment.

In South Africa, the epidemic of tuberculosis has become a problem, and many infected people have been infected with the super multidrug-resistant Mycobacterium tuberculosis. In 2006, the first multi-drug-resistant tuberculosis was found in the South African town of Tuguera Ferry, out of 53 confirmed cases of super-drug-resistant tuberculosis, 52 died. The median age is relatively young at 35 years, and many patients have never been treated for tuberculosis in the past, so other infected people are believed to have been super-drug-resistant Mycobacterium tuberculosis. Some patients were medical professionals, so they may have been infected by the patient who was treated.

The World Health Organization (WHO) conducted a survey on tuberculosis resistant to multi-drugs around the world, and as of 2006, not only South Africa but also 28 countries including the United States have already spread the drug I understand. Initially, the diagnosis of super-drug-resistant tuberculosis seemed almost equivalent to a death sentence, and the mortality rate could have exceeded 80%.

by NIAID

In recent years, treatments that are effective for super-drug-resistant tuberculosis are gradually being found, but the treatment is harsh. For example, a typical treatment for super multidrug-resistant tuberculosis in South Africa is to take up to 40 tablets a day for up to 2 years. Mycobacterium tuberculosis digs deep into the lungs and creates a barricade in the dead cell mass. To break apart those nodules and kill all the bacteria inside, you need to take medicine for a long time.

However, antibiotics cause symptoms such as diarrhea and nausea, which is a heavy burden on patients. In fact, even if many antibiotics are given as a treatment for super-drug-resistant tuberculosis, some patients may end up taking the side effects of antibiotics and die from tuberculosis. Some patients may experience hallucinations by taking a strong antibiotic over a long period of time, and some may cut their skin by thinking that there are insects under the skin. Also, it seems that the treatment of super multidrug-resistant tuberculosis is very painful, such as a patient suffering from severe tinnitus trying to commit suicide.

by qimono

A clinical trial of a new treatment for such a multi-drug resistant tuberculosis was conducted in South Africa. A clinical trial of a treatment called BPaL was named “ Nix-TB ” and was tested in South African patients with very multi-drug resistant tuberculosis. BPaL is Bedakirin - Puretomanido , linezolid in the treatment method using three types of medicine that has been the treatment of extensively drug-resistant tuberculosis in taking just one day 5 tablets.

Nix-TB was a small clinical trial with 109 subjects, but the effect was remarkable and over 90% of patients were saved by treatment. A woman named Tsholofelo Msimango, who had been treated, was once treated with super multidrug-resistant tuberculosis, but she could not stand the treatment with antibiotics and she stopped taking her and was dying. However, in 2019, five years after the treatment with BPaL, Msimango returned to a healthy body with a young son.

On August 14, 2019, the US Food and Drug Administration (FDA) also approved treatment with BPaL. WHO is also planning to accept BPaL based on FDA approval.

by Pixabay

On the other hand, treatment with BPaL is not without any side effects. When long-term administration of linezolid contained in BPaL to patients with tuberculosis for a long period of time, patients may have difficulty walking, and some groups have `` not done enough clinical trials '' for pretomanid. We express the opposite.

However, Dr. Mel Spiegelman, president of TB Alliance , a non-profit organization in New York that developed pretmanide, said, “Please put yourself in the patient's position,” “Three drugs with a cure rate of 90%. 'There are more than 20 drug options that have a low chance of healing. Who agrees with a randomized clinical trial?' He said that a randomized clinical trial would be very expensive and would take more than five years to confirm its effectiveness.

in Science, Posted by log1h_ik