- The National Health Services (NHS) of the U.K. has commissioned Janssen's Sirturo (bedaquiline) and Otsuka's Deltyba (delamanid) to be used for treatment of multidrug-resistant tuberculosis (MDR-TB).
- This is the first time that the NHS has commissioned new TB drugs in almost 50 years.
- The prevalence of TB is on the rise.
According to a report from the British government, about two billion people are infected with TB worldwide, representing 1/3 of the world's population. Each year, 1.5 million people die of TB. In the United Kingdom, the incidence of TB has been increasing, especially among homeless people, who are the most vulnerable to contracting TB in developed countries. NHS has added Sirturo and Deltyba to be used as part of combination therapy, because available therapies are often too difficult to take because of their toxicity and often only marginally effective.
In addition, both Sirturo and Deltyba bring something new to the table in terms of mechanism of action (MOA) and effectiveness against MDR-TB, which is especially difficult to treat. Sirturo kills the bacteria that causes TB by targeting adenosine triphosphate synthase. In placebo-controlled trials, Sirturo shorterned time to response and resulted in significantly improved cure rates, compared with placebo.
Deltyba also has a novel MOA, based on inhibition of mycolic acid biosynthesis, which is necssary for cell-wall formation in TB. In clinical trials, 45.4% of patients who received Deltyba became noninfectious after two months, compared with only 29.6% of placebo-treated patients.