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Updated: Jun 6, 2026

A High-throughput Compatible Assay to Evaluate Drug Efficacy against Macrophage Passaged Mycobacterium tuberculosis
10:29

A High-throughput Compatible Assay to Evaluate Drug Efficacy against Macrophage Passaged Mycobacterium tuberculosis

Published on: March 24, 2017

An update on recent developments in the drug treatment of tuberculous meningitis

Robert M Gray1,2, Sean Wasserman3,4,5, Robert J Wilkinson1,3,4,6

  • 1Francis Crick Institute, London, UK.

Expert Opinion on Pharmacotherapy
|June 5, 2026
PubMed
Abstract

Insights

Tuberculous meningitis (TBM) treatment has not improved outcomes despite decades of research. Future TBM therapies may focus on modulating the host

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Tuberculous meningitis (TBM) is a severe form of tuberculosis affecting the brain.
  • It leads to significant neurological damage and disability, with high mortality rates.
  • Current TBM treatment, unchanged for over 40 years, includes antitubercular drugs and glucocorticoids.

Purpose of the Study:

  • To review recent clinical trials and research on improving TBM treatment regimens.
  • To highlight upcoming trials and potential new therapeutic strategies for TBM.

Main Methods:

  • Literature search of PubMed (July 2019 - October 2025).
  • Inclusion of human pharmacokinetic studies and animal disease models.
  • Summary of recent clinical trial data and expert opinion.

Main Results:

  • Intensifying antitubercular therapy has not yet shown improved clinical outcomes for TBM.
  • Large trials are anticipated to report soon.
  • Evidence suggests a need to focus on modulating neuroinflammation rather than solely enhancing bacterial killing.

Conclusions:

  • Improving TBM survival may require better modulation of the host's neuroinflammatory response.
  • Further research into inflammatory mechanisms is crucial for targeted therapies.
  • Developing specific treatments for deleterious immune pathways is a key future direction.
Keywords:
Antitubercular therapyclinical trialshost-directed therapiespharmacokineticstuberculous meningitis

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