Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
Los Angeles Times - December 10, 2004
Thomas H. Maugh II
At least 8 million people contract TB each year and a quarter of them die, so there is a powerful demand for new drugs to treat strains of the bacterium that have become resistant to existing medications. Eleven million people have both TB and HIV, which renders them more susceptible to the disease's debilitating effects.
The new compound, developed by Dr. Koen Andries of Johnson & Johnson Pharmaceutical Research and Development in Beerse, Belgium, has been shown in mice to be effective against drug-resistant strains of Mycobacterium tuberculosis, the bacterium responsible for the devastating disease.
The compound, called R207910, works by a completely different mechanism than existing drugs, and preliminary studies in humans have shown that it is safe. Efficacy trials are now under way. Andries said in a news conference that the drug could be ready for marketing in as little as five years if the trials were successful.
The results of animal trials were published online Thursday by the journal Science and will appear in a January issue of the magazine.
TB is currently treated with a cocktail of three drugs: rifampin, isoniazid and pyrazinamide. But it takes nine months to eradicate M. tuberculosis from the body, and many patients stop taking the drugs prematurely, both because their symptoms have disappeared and because the drugs sometimes produce serious side effects. That early termination is the primary cause of the bacterium's growing resistance to the drugs.
The Johnson & Johnson researchers stumbled across a predecessor of the new drug while they were screening chemicals looking for new antibiotics. That chemical belonged to a class of compounds called diarylquinolines. It was not much good against most bacteria, but it did seem to be effective against Mycobacterium smegmatis, which is closely related to the TB bug.
Modifications in the original compound led to R207910, which surprised researchers with its effectiveness in mice. The drug inhibits an enzyme called ATP synthase, which plays a crucial role in providing energy for the bacterium.
"You could describe what the drug does as cutting off energy for the bacteria -- turning off the lights, you could say," Andries said.
More important, it does it much more quickly than other drugs, eradicating all traces of bacteria from mice in two months, compared to the four months required by other drugs.
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