Challenges and opportunities in tuberculosis drug discovery: An industry perspective

摘要

Tuberculosis (TB) accounts for approximately 2 million deaths every year, mainly affecting the developing world [1,2]. Over the past 40 years, drug-discovery efforts from major pharmaceutical companies have not yielded a single novel drug for TB, further complicating the global health situation due to the increasing resistance of Mycobacterium tuberculosis to the available drug regimens [3]. In recent years, TB drug discovery has been rejuvenated thanks to the efforts from many nonprofit organizations, such as the Global Alliance for TB [4], European Union Frame Work Program and others in collaboration with the pharmaceutical industry [101,102]. It is gratifying to see the recent accelerated approval by the US FDA for Johnson & Johnson's Sirturo? (bedaquiline) [5,103], a diarylquinolone antimycobacterial drug for treating multidrug-resistant TB. This approval has come with a heavy burden for post-marketing studies and it remains to be seen whether the drug will have a significant impact in treating TB patients. Recently, AstraZeneca, in collaboration with the National Institute of Allergy and Infectious Diseases, has launched a mid-stage trial of its investigational TB drug, AZD5847 [6,io4], to determine its effectiveness as a potential new treatment against TB. This editorial aims to provide an insight into different approaches from the viewpoint of the pharmaceutical industry on the discovery of new medicines for TB, focusing on the associated risks and benefits, and highlighting some of the current efforts in this field.