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Prospects of Inhalable Formulations of Conventionally Administered Repurposed Drugs for Adjunctive Treatment of Drug-Resistant Tuberculosis: Supporting Evidence from Clinical Trials and Cohort Studies.
J Aerosol Med Pulm Drug Deliv
December 2024
Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas, USA.
Article Synopsis
- Drug-resistant tuberculosis (TB) poses a significant public health issue, particularly in low-income areas, where resistance rates can exceed 25%, and treatment can last 9-12 months with less favorable outcomes.
- Conventional treatments for drug-resistant TB face challenges such as poor drug delivery to the lungs, drug interactions, and severe side effects, highlighting the need for more effective delivery methods.
- Inhalable formulations, particularly those using repurposed drugs, present a promising strategy to improve treatment outcomes by targeting the infection directly at the site in the lungs, although research in this area is still limited.
Targeted next-generation sequencing to diagnose drug-resistant tuberculosis: a systematic review and meta-analysis.
Lancet Infect Dis
October 2024
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. Electronic address:
Article Synopsis
- This study aimed to evaluate targeted next-generation sequencing (NGS) as a method for diagnosing drug-resistant tuberculosis by reviewing existing data on its effectiveness and prevalence in detecting mutations across different gene targets.
- The researchers conducted a systematic review and meta-analysis of various sources for publications related to targeted NGS from 2005 to 2022, focusing on studies that utilized the technique for drug resistance prediction in tuberculosis.
- They assessed the diagnostic accuracy of targeted NGS by analyzing sensitivity and specificity compared to traditional drug susceptibility testing methods, using a Bayesian model for comprehensive results.
Whole-Genome Sequencing Predicting Phenotypic Antitubercular Drug Resistance: Meta-analysis.
J Infect Dis
May 2024
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Article Synopsis
- Whole genome sequencing (WGS) can be used to predict drug resistance in tuberculosis either through a catalog-based method that identifies specific mutations or a noncatalog approach using advanced algorithms like machine learning.
- A systematic review analyzed 44 studies with nearly 17,000 specimens, revealing excellent test accuracy for isoniazid and rifampicin, very good accuracy for several other drugs, and good accuracy for a few more.
- Both catalog-based and noncatalog-based methods demonstrated similar effectiveness in predicting drug susceptibility using WGS results.
Pharmacological Management of Pulmonary Tuberculosis: A Century of Expert Opinions in Cecil Textbook of Medicine.
Am J Ther
January 2023
Transilvania University, Brasov, Romania.
Background: Advances in drug therapy for pulmonary tuberculosis have had an extraordinary impact on the incidence of tuberculosis in the United States in the past century, which has decreased from 113/100,000 persons in 1920 to 2.2/100,000 in 2020. Modern treatments have contributed to a remarkable decrease in hospitalizations and mortality and have had a significant impact on the duration and severity of illness, quality of life, and work potential of affected persons.
View Article and Find Full Text PDFDetection of isoniazid, fluoroquinolone, ethionamide, amikacin, kanamycin, and capreomycin resistance by the Xpert MTB/XDR assay: a cross-sectional multicentre diagnostic accuracy study.
Lancet Infect Dis
February 2022
FIND, Geneva, Switzerland.
Background: The WHO End TB Strategy requires drug susceptibility testing and treatment of all people with tuberculosis, but second-line diagnostic testing with line-probe assays needs to be done in experienced laboratories with advanced infrastructure. Fewer than half of people with drug-resistant tuberculosis receive appropriate treatment. We assessed the diagnostic accuracy of the rapid Xpert MTB/XDR automated molecular assay (Cepheid, Sunnyvale, CA, USA) to overcome these limitations.
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