Newer drugs and targets in tuberculosis

In the year 2013, nine million people suffered from tuberculosis. Around 1.5 million people (men, woman and children) died due to tuberculosis. About 1.1 million people with HIV developed tuberculosis. The major drawbacks of tuberculosis treatment in a patient are multidrug resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB). Recently newer drugs and targets have been the key focus of research in finding the permanent cure for tuberculosis. The FDA has recently approved a new tuberculosis drug bedaquiline. The drugs under trials are delamanid, pretomanid, sutezolid and SQ109. Drugs in preclinical development showing promising results are benzothiazinone, spectinamide, capuramycin, TBI-166 (Riminophenazines antibiotic). The various lead compounds which showed promising activity against mycobacterial tuberculosis are SPR113, cyclopeptides, ruthenium complexes, leucyl-t-RNA inhibitors, inhA inhibitors. The various hits during drug discovery shown to have effect against tuberculosis infection are ATP synthesis inhibitors, RNA polymerase inhibitors, energy metabolism inhibitors, menaquinone inhibitors and malate synthesis inhibitors. Biologics have shown to improve the treatment outcome in tuberculosis but are still in trial or in drug development. They are immunoxel, HE2000, Oral mycobactriumvaccae(V7), TGF-Inhibition + COX-2 inhibition, IL-4 antibody. Some of the old drugs which have found to be effective against tuberculosis are: High dose rifampin, statins, meropenem+clavulanate, nitazoxanide.