Sterilizing Activity of Second-Line Regimens Containing TMC207 in a Murine Model of Tuberculosis
Date
2011-03-03
Authors
Veziris, Nicolas
Ibrahim, Murad
Lounis, Nacer
Andries, Koen
Jarlier, Vincent
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science
Abstract
Rationale: The sterilizing activity of the regimen used to treat multidrug resistant tuberculosis (MDR TB) has not been
studied in a mouse model.
Objective and Methods: Swiss mice were intravenously inoculated with 6 log10 of Mycobacterium tuberculosis (TB) strain
H37Rv, treated with second-line drug combinations with or without the diarylquinoline TMC207, and then followed without
treatment for 3 more months to determine relapse rates (modified Cornell model).
Measurements: Bactericidal efficacy was assessed by quantitative lung colony-forming unit (CFU) counts. Sterilizing efficacy
was assessed by measuring bacteriological relapse rates 3 months after the end of treatment.
Main Results: The relapse rate observed after 12 months treatment with the WHO recommended MDR TB regimen
(amikacin, ethionamide, pyrazinamide and moxifloxacin) was equivalent to the relapse rate observed after 6 months
treatment with the recommended drug susceptible TB regimen (rifampin, isoniazid and pyrazinamide). When TMC207 was
added to this MDR TB regimen, the treatment duration needed to reach the same relapse rate dropped to 6 months. A
similar relapse rate was also obtained with a 6-month completely oral regimen including TMC207, moxifloxacin and
pyrazinamide but excluding both amikacin and ethionamide.
Conclusions: In this murine model the duration of the WHO MDR TB treatment could be reduced to 12 months instead of
the recommended 18–24 months. The inclusion of TMC207 in the WHO MDR TB treatment regimen has the potential to
further shorten the treatment duration and at the same time to simplify treatment by eliminating the need to include an
injectable aminoglycoside.
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Citation
Veziris N, Ibrahim M, Lounis N, Andries K, Jarlier V (2011) Sterilizing Activity of Second-Line Regimens Containing TMC207 in a Murine Model of Tuberculosis. PLoS ONE 6(3): e17556. doi:10.1371/journal.pone.0017556