Tuberculosis cocktail stirs hopes for quick cures in patients with HIV

A new three-drug combo treatment for tuberculosis was better at eradicating the disease than standard therapy in a midstage trial, showing particular promise for patients with HIV as it rolls into Phase III development.

The oral treatment, dubbed PaMZ, is the work of the nonprofit TB Alliance and combines two antibacterials with pyrazinamide, a long-standing first-line treatment for TB. In a 200-patient study, the combo posted a 71% cure rate compared to just 38% with standard therapy, The Sydney Morning Herald reports, and, importantly, the treatment didn't interfere with the antivirals taken by participants with HIV.

HIV sufferers are about 30 times more likely to develop the disease, according to Bloomberg, and TB kills about one in 5 people infected with the virus around the world. Further complicating matters, some of the key treatments currently used to treat TB aren't compatible with HIV-fighting therapies, TB Alliance told the Herald, creating a desperate need for new solutions.

That makes the new PaMZ data, revealed at the International AIDS Conference in Melbourne, especially promising, TB Alliance President Mel Spigelman told Bloomberg, and the treatment's next big challenge is a sweeping Phase III study funded in part by the Bill & Melinda Gates Foundation.

The STAND (Shortening Treatments by Advancing Novel Drugs) trial will involve 50 sites on four continents, testing PaMZ on about 1,500 patients to see if the treatment can quickly and reliably cure TB without the need for injections and without disrupting HIV treatment.

If approved, the treatment would be about 90% less expensive than existing treatments for drug-resistant forms of the disease, TB Alliance said, making it ideal for underprivileged parts of the world where TB is especially deadly.

The combo includes PA-824, an antibacterial initially developed by the Novartis ($NVS)-acquired Chiron; moxifloxacin, an antibiotic marketed by Bayer as Avelox; and pyrazinamide, which has been part of standard TB therapies since the 1980s, according to the alliance.

- read the Herald story
- here's Bloomberg's take