Alignment of new tuberculosis drug regimens and drug susceptibility testing: a framework for action - PubMed (original) (raw)

Review

doi: 10.1016/S1473-3099(13)70025-2. Epub 2013 Mar 24.

Catharina C Boehme, Frank G J Cobelens, Colleen Daniels, David Dowdy, Elizabeth Gardiner, Jan Gheuens, Peter Kim, Michael E Kimerling, Barry Kreiswirth, Christian Lienhardt, Khisi Mdluli, Madhukar Pai, Mark D Perkins, Trevor Peter, Matteo Zignol, Alimuddin Zumla, Marco Schito

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Review

Alignment of new tuberculosis drug regimens and drug susceptibility testing: a framework for action

William A Wells et al. Lancet Infect Dis. 2013 May.

Abstract

New tuberculosis drug regimens are creating new priorities for drug susceptibility testing (DST) and surveillance. To minimise turnaround time, rapid DST will need to be prioritised, but developers of these assays will need better data about the molecular mechanisms of resistance. Efforts are underway to link mutations with drug resistance and to develop strain collections to enable assessment of new diagnostic assays. In resource-limited settings, DST might not be appropriate for all patients with tuberculosis. Surveillance data and modelling will help country stakeholders to design appropriate DST algorithms and to decide whether to change drug regimens. Finally, development of practical DST assays is needed so that, in countries where surveillance and modelling show that DST is advisable, these assays can be used to guide clinical decisions for individual patients. If combined judiciously during both development and implementation, new tuberculosis regimens and new DST assays have enormous potential to improve patient outcomes and reduce the burden of disease.

Copyright © 2013 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd. All rights reserved.

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Conflict of interest statement

Conflicts of Interest

David Alland led the development of the Cepheid Xpert MTB/RIF assay and receives royalties from licensing fees from the UMDNJ molecular beacon patent pool for the use of molecular beacons in this assay, served as an ad hoc member of the Cepheid advisory board in 2010 and received a contract from Cepheid to performs clinical testing of a new version of the Xpert MTB/RIF assay. David Dolinger in employed by Seegene, Inc. William Wells, Khisi Mdluli and Elizabeth Gardiner are employed by the TB Alliance, whose mission is to develop new, improved regimens for tuberculosis. Lee Pyne-Mercier works for the Bill & Melinda Gates Foundation which supports development of new tuberculosis diagnostics and drug regimens. Frank Cobelens serves as a consultant to the Foundation for Innovative New Diagnostics (FIND). Frank Cobelens and Madhukar Pai serve as consultants for the Bill & Melinda Gates Foundation. All other authors declare no conflicts of interest.

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References

    1. Raviglione M, Marais B, Floyd K, Lonnroth K, Getahun H, Migliori GB, et al. Scaling up interventions to achieve global tuberculosis control: progress and new developments. Lancet. 2012;379(9829):1902–13. - PubMed
    1. Stop TB Partnership. Introducing new approaches and tools for enhanced TB control (INAT) subgroup of the DOTS Expansion Working Group. [cited November 23, 2010]; Available from: http://www.stoptb.org/wg/dots_expansion/inatabout.asp.
    1. Ma Z, Lienhardt C, McIlleron H, Nunn AJ, Wang X. Global tuberculosis drug development pipeline: the need and the reality. Lancet. 2010;375(9731):2100–9. - PubMed
    1. Wells WA, Konduri N, Chen C, Lee D, Ignatius HR, Gardiner E, et al. TB regimen change in the high burden countries. Int J Tuberc Lung Dis. 2010;14:1538–47. - PubMed
    1. Wells WA, Ge CF, Patel N, Oh T, Gardiner E, Kimerling ME. Size and usage patterns of private TB drug markets in the high burden countries. PLoS One. 2011;6(5):e18964. - PMC - PubMed

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