December 14, 2015

A drug for childhood tuberculosis

Finally children already got the drug against tuberculosis. This infectious disease especially strikes the poorest among the poor, which makes the industry shows little interest in developing vaccines or treatments for it, since their potential beneficiaries tend to be people who could hardly afford them.

If we speak of tuberculosis in children, this therapeutic forgetting is even greater, since the affected part is smaller and helpless. Such ostracism is reflected in that, there is no specific drug to treat 140,000 children dying each year from this disease.

In 2010, the World Health Organization (WHO) revised its guidelines on pediatric tuberculosis, and then warned that one million children suffering from the disease worldwide in need of other therapeutic options that they were getting. But five years later, no large pharmaceutical company has expressed interest in developing a specific product for them.

Thus, the lack of special treatment leaves doctors and families alternative but to adjust their own treatments of adults. Thus, to medicate a child you have to chop and mix pills with adults up to the amount sufficient for the child.

However, this leads to many problems and makes treatment not so effective it could be, and that is not always succeeds with the proper dosage. What happens with tuberculosis in children is very similar to what happened today with HIV, we had to use adult formulations, breaking pills and doing alchemy.

To end this situation, the Alliance for Tuberculosis has been working in recent years in the design and development of a specific treatment for childhood tuberculosis. And now the day has come to make it known: from now we can say that there is a child-friendly treatment for tuberculosis in children follows the WHO recommendations.

Several pills together in one are appropriate for a child – it is something pharmacologically very complicated and finally has been achieved. Some lower expectations of this therapy, warning that this not going to change anything, because in the end, the children were healing like medication that already existed.

Experts explain that the main problem of tuberculosis in childhood is not so much the lack of a suitable treatment, but the difficulty of diagnosis. In fact, this problem is of such magnitude that the Lancet warned in 2014 that estimates of tuberculosis in children fall short, and that the real figure is twice more than at first thought.

The innovation introduced by the treatment presented today is not so much in its composition but in its design as it does not consist of new drugs, but improved three existing combination of compounds: rifampin, isoniazid and pyrazinamide. This therapy is a new combination with the correct dose, which means that the child takes fewer pills and no longer have to mash and mix them. New medicine also dissolves easily in water, so it is more accepted among children.

Six months of treatment

The product has been manufactured by Macleods, a small pharmaceutical company in India, and the cost of a complete treatment for an infected child, that would last about six months, would be about 16 USD. The dose would not be determined by age, but by weight. Thus, the price was calculated based on an estimated average weight, but those who weigh more should take a larger amount. Children who weigh over 25 kilos should follow the treatment of adults.

The formula presented today is for sensitive tuberculosis, the most common, but not for multidrug-resistant (MDR-TB) and XDR (XDR-TB), but less prevalent more complicated.

In any case, what is clear is that although the formula used existing combinations and doses, this time, are adapted and have an acceptable flavor, is progress, at least on a practical level, for families. At present, the therapy is being prequalified by WHO, but it is being distributed in some countries through the Stop TB Partnership alliance. Prequalification is expected to be completed in 2016 and will then be available for more.

Category : Tuberculosis