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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Early bactericidal activity and pharmacokinetics of PA-824 in smear-positive tuberculosis patients
Antimicrobial Agents and Chemotherapy, Volume 54, No. 8, Year 2010
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Description
PA-824 is a novel nitroimidazo-oxazine being evaluated for its potential to improve tuberculosis (TB) therapy. This randomized study evaluated safety, tolerability, pharmacokinetics, and extended early bactericidal activity of PA-824 in drug-sensitive, sputum smear-positive, adult pulmonary tuberculosis patients. Fifteen patients per cohort received 1 of 4 doses of oral PA-824: 200, 600, 1,000, or 1,200 mg per day for 14 days. Eight subjects received once daily standard antituberculosis treatment as positive control. The primary efficacy endpoint was the mean rate of change in log CFU of Mycobacterium tuberculosis in sputum incubated on agar plates from serial overnight sputum collections, expressed as log10 CFU/day/ml (± standard deviation [SD]). The drug demonstrated increases that were dose linear but less than dose proportional in serum concentrations in doses from 200 to 1,000 mg daily. Dosing of 1,200 mg gave no additional exposure compared to 1,000 mg daily. The mean daily CFU fall under standard treatment was 0.148 (±0.055), consistent with that found in previous studies. The mean daily fall under PA-824 was 0.098 (±0.072) and was equivalent for all four dosages. PA-824 appeared safe and well tolerated; the incidence of adverse events potentially related to PA-824 appeared dose related. We conclude that PA-824 demonstrated bactericidal activity over the dose range of 200 to 1,200 mg daily over 14 days. Because maximum efficacy was unexpectedly achieved at the lowest dosage tested, the activity of lower dosages should now be explored. Copyright © 2010, American Society for Microbiology. All Rights Reserved.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2916303/bin/supp_54_8_3402__index.html
https://efashare.b-cdn.net/share/pmc/articles/PMC2916303/bin/supp_54_8_3402__supplemental_tables.zip
Authors & Co-Authors
Diacon, Andreas Henri
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
South Africa, Bellville
Karl Bremer Hospital
Dawson, Rodney
South Africa, Cape Town
University of Cape Town Lung Institute
Hanekom, Madeleine
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
South Africa, Bellville
Karl Bremer Hospital
Narunsky, Kim
South Africa, Cape Town
University of Cape Town Lung Institute
Maritz, Stefan J.
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Venter, Amour
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Donald, Peter Roderick
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
van Niekerk, Christo H.
United States, New York
Global Alliance for tb Drug Development
Whitney, Karl
United States, Research Triangle Park
Rti International
Rouse, Doris J.
United States, Research Triangle Park
Rti International
Laurenzi, Martino W.
United States, New York
Global Alliance for tb Drug Development
South Africa, Pretoria
Global Alliance for tb Drug Development
Ginsberg, Ann M.
United States, New York
Global Alliance for tb Drug Development
South Africa, Pretoria
Global Alliance for tb Drug Development
Spigelman, Melvin K.
United States, New York
Global Alliance for tb Drug Development
South Africa, Pretoria
Global Alliance for tb Drug Development
Statistics
Citations: 167
Authors: 13
Affiliations: 6
Identifiers
Doi:
10.1128/AAC.01354-09
ISSN:
00664804
e-ISSN:
10986596
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study