Despite high TB rates in Africa, residents often excluded from drug trials
These findings were revealed at the recent European Respiratory Society's International Congress 2015 in Amsterdam.
Dr. Florian von Groote-Bidlingmaier, director of Task Applied Science, which performs clinical trials on tuberculosis (TB) in Cape Town, South Africa, there is a great need to develop new TB treatment drugs. Through studies, von Groote-Bidlingmaier and his team found that the reasons why African HIV patients were excluded from TB drug testing included low white blood cell counts; not having multi-drug-resistant TB, but instead resistance to rifampicin (an anti-TB drug); or death before testing could begin.
"HIV infection with a low CD4 count and anti-retroviral therapy were the number one reasons for nonconsideration for inclusion in pivotal clinical trials of a novel anti-tuberculosis drug," von Groote-Bidlingmaier said. "We need new anti-TB drugs, and we need to develop them fast. Drug development is a lengthy and expensive process and should be accelerated as much as possible. It is very, very difficult to recruit suitable patients with multi-drug-resistant TB for trials of new drugs. Inclusion of HIV patients early on would increase the number of participants and the relevance of the results."
In addition, von Groote-Bidlingmaier said the lack of effective TB drugs, particularly those that could be taken by HIV patients, was a problem not only in Africa, but also around the world for nations with high rates of TB and HIV cases.
"South Africa is one of the few countries where bedaquiline (one of the new TB drugs) is available without cost to the patient," von Groote-Bidlingmaier said. "This is a great success and a major breakthrough 10 years after the first clinical trial with bedaquiline was done in Cape Town. Close collaboration between research groups and the government health care system is key to efficient drug development. The communities participating in these trials will benefit from that type of research directly."