echemi logo
Product
  • Product
  • Supplier
  • Inquiry
    Home > Active Ingredient News > Infection > How effective is the host-oriented adjuvant treatment of tuberculosis? Which drugs can be used?

    How effective is the host-oriented adjuvant treatment of tuberculosis? Which drugs can be used?

    • Last Update: 2021-04-18
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com
    Tuberculosis is one of the main causes of global morbidity and mortality, and there is a phenomenon of insufficient treatment.
    At present, the treatment of tuberculosis mainly requires patients to adhere to a long-term complex and difficult to tolerate or even ineffective multi-drug treatment regimen.
    Even if most patients are cured , Will also leave sequelae such as bronchiectasis and fibrosis.

    These sequelae not only impair lung function, but also increase the risk of long-term mortality.

    In recent years, researchers have become more and more interested in host-directed therapy (HDT), a new and effective auxiliary treatment method for tuberculosis.

    As modulators of the host's immune response, these treatments can protect the lungs, improve long-term survival, and shorten the duration of treatment by reducing lung inflammation, improving drug penetration in the lesion, and inducing antibacterial activity in phagocytes.

    Although HDT has many advantages, it is rarely clinically tested, so there are still many questions about how to evaluate their best effect.

    Therefore, the team of Professor Wallis from the Yale University School of Public Health recently published a study in the journal Lancet to evaluate the four host orientations of CC-11050, Everolimus, Anranofin and Vitamin D (ergocalciferol).
    The safety and preliminary efficacy of adjuvant therapy drugs in patients with refractory tuberculosis.

     Research Method This study is a prospective, open-ended, randomized controlled phase 2 study.
    Researchers recruited tuberculosis patients at three clinical sites in South Africa and randomly assigned eligible patients (1:1:1:1:1:1) ), each group of 10 people received 4 kinds of oral host-directed therapy drugs combined with standard tuberculosis treatment or standard tuberculosis treatment alone (control group).The host-directed therapy drugs are CC-11050 (200 mg, twice a day, taken with food; 1st to 112d); Everolimus (0.
    5 mg/d; 1st to 112d); Anranofin (3 mg/ d, a total of 7 doses, then 6 mg/d; 1st to 112th days); ergocalciferol (5 mg on day 1, 2.
    5 mg on day 28 and 56).

    The main outcome was the safety and tolerability of the 4 host-directed therapies at day 210.

    The secondary primary efficacy outcome was the sputum microbes measured by vital capacity at the 56th day, 180th day and 540th day (the culture status on the 56th day and the hazard ratio of the stable culture conversion to 180 days) and lung function (FEV1 and forced vital capacity [FVC] ) The therapeutic effect.

     Results of the study ➤11 cases of serious adverse events occurred, of which 3 cases may be related to host-directed therapy: (1) An Anranofin subject developed thrombocytopenia 53 days after entering the study.
    After stopping the drug, the thrombocytopenia was not present.
    Alleviated with any medication; (2) Another Anranofin subject developed acute gastroenteritis 2 weeks after entering the study, followed by rapid hypotension, diffuse intravascular coagulation and hypoxemia; ( 3) A subject receiving ergocalciferol treatment developed tuberculous spondylitis 7 weeks after entering the study.

     ➤In the population of the host-oriented treatment program, compared with the standard treatment alone, none of the four targeted treatment methods had a significant impact on the sputum microbial culture status on day 56 or the risk ratio of stable culture conversion on day 180.

     ➤The average FEV1 of patients in the control group was 61.
    7% (95%CI: 56.
    3-67.
    1) predicted at baseline and 69.
    1% (62.
    3-75.
    8) on day 180.
    Most of the significant increases occurred in the early stages of standard treatment.

    Except for the ergocalciferol group, all other groups showed a significant increase in FEV1 from baseline to day 14.

    All treatments did not affect FEV1 on day 56, but the average FEV1 of CC-11050 group and everolimus group on day 180 improved (6.
    30, 95% CI: 0.
    06-12.
    54, p=0.
    048 and 6.
    56, respectively) , 95%CI: 0.
    18-12.
    95, p=0.
    044).  Research conclusions This study is the first to recruit patients with refractory pulmonary tuberculosis at risk of poor prognosis based on chest X-ray examination and sputum microbiological examination, and to test the effects of four host-oriented drugs in the treatment of tuberculosis.

    Among the four targeted treatment drugs, the researchers found that CC-11050 and everolimus showed sufficient safety and tolerability in the treatment of tuberculosis patients.

    Therefore, it is necessary to conduct in-depth research on CC-11050 and everolimus in patients with tuberculosis in the future.

     Yimaitong compiled from: WallisR S, Ginindza S, Beattie T, et al.
    Adjunctive host-directed therapies forpulmonary tuberculosis: a prospective, open-label, phase 2, randomised controlled trial[J].
    Lancet Respir Med, 2021.
    This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Related Articles

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent ECHEMI's opinion. If you have any queries, please write to service@echemi.com. It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to service@echemi.com with relevant evidence.