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Pretomanid: The latest USFDA-approved anti-tuberculosis drug

Uttiya Deb1, Supreeti Biswas1

  • 1Department of Pharmacology, Burdwan Medical College, Burdwan.

The Indian Journal of Tuberculosis
|April 13, 2021
PubMed

Insights

Pretomanid, a novel drug, effectively treats multidrug-resistant tuberculosis by disrupting bacterial cell walls. Approved in 2019, it shows promise in combination therapy for extensive drug-resistant tuberculosis.

Area of Science:

  • Pharmacology and Microbiology
  • Drug Discovery and Development

Background:

  • Tuberculosis (TB) remains a significant global health challenge, particularly drug-resistant strains.
  • Mycolic acid synthesis is crucial for Mycobacterium tuberculosis cell wall integrity.
  • Limited treatment options exist for extensively drug-resistant tuberculosis (XDR-TB) and multidrug-resistant tuberculosis (MDR-TB).

Purpose of the Study:

  • To introduce pretomanid, a novel nitroimidazooxazine drug.
  • To highlight its mechanism of action against Mycobacterium tuberculosis.
  • To discuss its recent approval and therapeutic role in resistant TB.

Main Methods:

  • Pretomanid targets mycolic acid synthesis, a key component of the mycobacterial cell wall.
  • Its efficacy was demonstrated in a Phase III clinical trial.
  • Approved as part of the bedaquiline, pretomanid, and linezolid (BPaL) regimen.

Main Results:

  • Pretomanid inhibits mycolic acid synthesis, leading to bacterial cell death.
  • The drug is active against both replicating and non-replicating Mycobacterium tuberculosis.
  • The BPaL regimen showed promising results in treating adults with XDR-TB or treatment-intolerant/non-responsive MDR-TB.

Conclusions:

  • Pretomanid represents a significant advancement in the treatment of drug-resistant tuberculosis.
  • Further research is needed to evaluate its use in pediatric, geriatric, and HIV co-infected populations.
  • The BPaL regimen offers a new therapeutic option for complex TB cases.
Keywords:
Extensive drug resistanceMultidrug resistancePretomanidTuberculosis

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