New drugs for the management of tuberculosis
Abstract
Purpose of review: This review summarizes recent and emerging advances in tuberculosis (TB) treatment, focusing on new therapeutics, repurposed agents, and shortened treatment regimens. It aims to contextualize key developments within the evolving TB treatment landscape and assess their potential to transform clinical management of both drug-susceptible and drug-resistant disease.
Recent findings: Evidence from landmark trials, including Nix-TB, ZeNix, TB-PRACTECAL, STREAM, Study 31/A5349, SHINE, TRUNCATE-TB, endTB and BEAT-TB has supported the use of licensed, repurposed, and novel agents as new treatment strategies. These studies have demonstrated the feasibility of treatment-shortening regimens for drug-susceptible TB and improved outcomes for multidrug-resistant TB. Progress has expanded the therapeutic armamentarium, with promising regimens incorporating new agents, higher-dose rifamycins, and safer, all-oral combinations.
Summary: These advances have direct implications for clinical practice, offering shorter, safer, and more effective treatment options. Adoption of these new regimens into treatment guidelines will allow us to reduce treatment burden, improve adherence, and lower the risk of adverse effects. Continued optimization of drug combinations, dosing strategies, and safety profiles will be essential to achieving durable, scalable treatment options. Future research should prioritize regimen simplification, host-directed therapies, and tools for predicting and…
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