Should TB Treatment Move into Long-Acting Injectables?

While at the earliest stages of potential development, long-acting/extended release (LA/ER) formulations for treatment and prevention of TB could be something to be studied in the future.

One novel treatment that is being considered is Long-Acting/Extended Release (LA/ER) formulations for treatment and prevention of TB. It is very early in the process, but pre-clinical animal models have shown proof of concept for treatment of latent TB, Eric Nuermberger, MD, associate professor of Medicine and International Health at Johns Hopkins University, explained.

He has been involved in these animal model studies looking at Isoniazid in LA/ER and is encouraged by what he has seen thus far in a very limited study. “I have seen efficacy lasting beyond 1 month even to 2 months with a single injection in the mice.” He acknowledges this is very early in the process and it would take more work to transition to humans, but he would like to see clinical trials studying it.

Nuermberger presented at a symposium at CROI this week on “The Potential of Long-Acting Injectable Drugs for Prevention and Treatment for TB.”

To learn more about the conference, check out our coverage here: Conference on Retroviruses and Opportunistic Infections (CROI) 2021 virtual sessions.

Nuermberger says he is not aware of any plans at this point to advance Isoniazid LA/ER to clinical trial and believes the demand should come from interested parties including providers and patients to make the case for further development. He also says this would take investment from public and non-profit foundations.

For his part, Nuermberger is a member of the LEAP-TB group. It is a small group made up of academics, clinicians, and industry people who are interested in LA/ER therapies for TB.

In the first interview segment with Contagion, Nuermburger talked about looking at long-acting injectables to treat latent and active tuberculous (TB) and how it could open up the door to possibly bundling HIV and TB care together.

In this segment, he discusses his insights on LA/ER therapies, LEAP-TB, and the lack of market incentives for TB therapies.