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Published on: March 24, 2017
An update on the use of rifapentine for tuberculosis therapy
John Gar Yan Chan1, Xiaoxue Bai, Daniela Traini
1The University of Sydney, Respiratory Technology, Woolcock Institute of Medical Research and Discipline of Pharmacology, Sydney Medical School , NSW 2037, Sydney , Australia +61 2 91140352 ; daniela.traini@sydney.edu.au.
Introduction:
Tuberculosis (TB) remains rampant throughout the world, in large part due to the lengthy treatment times of current therapeutic options. Rifapentine, a rifamycin antibiotic, is currently approved for intermittent dosing in the treatment of TB. Recent animal studies have shown that more frequent administration of rifapentine could shorten treatment times, for both latent and active TB infection. However, these results were not replicated in a subsequent human clinical trial.
Areas Covered:
This review analyses the evidence for more frequent administration of rifapentine and the reasons for the apparent lack of efficacy in shortening treatment times in human patients. Inhaled delivery is discussed as a potential option to achieve the therapeutic effect of rifapentine by overcoming the barriers associated with oral administration of this drug. Avenues for developing an inhalable form of rifapentine are also presented.
Expert Opinion:
Rifapentine is a promising active pharmaceutical ingredient with potential to accelerate treatment of TB if delivered by inhaled administration. Progression of current fundamental work on inhaled anti-tubercular therapies to human clinical trials is essential for determining their role in future treatment regimens. While the ultimate goal for global TB control is a vaccine, a short and effective treatment option is equally crucial.
Insights
Frequent administration of rifapentine shows promise for tuberculosis (TB) treatment. Inhaled delivery may overcome oral administration barriers, potentially shortening TB therapy duration.
Area of Science:
- Pharmacology
- Infectious Diseases
- Drug Delivery Systems
Background:
- Tuberculosis (TB) treatment is prolonged, contributing to its global prevalence.
- Rifapentine, an approved rifamycin, is used for intermittent TB therapy.
- Animal studies suggested frequent rifapentine administration could shorten TB treatment, but human trials did not confirm this.
Purpose of the Study:
- To review evidence on frequent rifapentine administration for TB.
- To explore reasons for its lack of efficacy in human trials.
- To discuss inhaled rifapentine as a potential alternative delivery method.
Main Methods:
- Literature review of rifapentine efficacy and administration.
- Analysis of barriers to oral rifapentine administration.
- Exploration of inhaled drug delivery for TB treatment.
Main Results:
- Frequent oral rifapentine did not shorten TB treatment in humans as predicted by animal studies.
- Inhaled delivery presents a potential strategy to enhance rifapentine's therapeutic effect.
- Development pathways for inhalable rifapentine are under consideration.
Conclusions:
- Inhaled rifapentine holds promise for accelerating TB treatment.
- Further research and clinical trials on inhaled anti-tubercular therapies are critical.
- Short, effective TB treatment options are vital alongside vaccine development.
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