The New Combination 1 (NC1) study used two new drugs and one old TB drug, testing this on 15 patients in Cape Town, according to the Lancet journal published yesterday (23 July).

Principal investigator, Stellenbosch University’€™s Professor Andreas Diacon, said the trial heralded a new approach to TB drug development.

‘€œNew candidate drugs are usually added to existing drug regimens one at a time over a number of years. But this trial involved combining two new drugs with one old TB drug,’€ said Prof Diacon.

The new combination was twice as strong over the first two weeks of treatment as the current regimen and ‘€œthis is a very good indication that we can develop a potent new regimen with them,’€ said Professor Diacon.

If follow-up trials support these results, scientists believe that TB, including some forms of drug-resistant TB, could be cured within four months.

At present, people with multi-drug resistant TB (MDR-TB) require some 28 months of treatment while those with ordinary TB take daily pills for six months.

‘€œA new regimen like this holds tremendous potential for those with multiple-drug resistant TB,’€ said Dr Mel Spigelman, CEO and President of TB Alliance, which spearheaded the trial.

‘€œWe could be reducing their treatment by two years or even longer. The regimen also promises to be 90 percent cheaper than the current regimens. That means we could soon have a dramatically shorter, simpler, cheaper and more effective treatment.’€

A second trial called New Combination 2 has already been launched to test the combination over two months in patients at eight sites in South Africa, Tanzania and Brazil.

Dr Mario Raviglione of the World Health Organization, said testing multiple new TB drug candidates simultaneously has already proven to be a major advance.

‘€œBecause of testing drugs in combination, we have already saved several years in the research process to find new, effective regimens to treat TB,’€ Raviglione said.

‘€œThe results look strongly promising from this early trial. If further testing holds up these results and the regimen is affordable in poor countries, it is huge progress. We could shorten drug regimens substantially for everyone, regardless of whether the form of TB is sensitive or multi-drug resistant. That would be a dramatic step forward.’€

The drugs involved are a new drug candidate called PA-824; moxifloxacin, an antibiotic not yet approved for use in first-line TB therapy and pyrazinamide, an existing TB drug.