Antitubercular Agents and Tubercular Vaccines in Clinical Trials

In 2015, an estimated 10.4 million people were infected with and 1.8 million people were killed by tuberculosis (TB). Multi-drug resistant (MDR) and extensively drug resistant (XRD) TB were other reported complications in the treatment of TB. Almost 3.3% of new TB cases and 20% of previously treated cases have multi-drug resistance (MDR) TB while 9.7% of people with MDR-TB have XDR-TB. Recently, two chemical entities, namely bedaquiline and delamanid were granted conditional approval for the treatment of MDR-TB, and are recommended only to those patients for whom other treatments fail to cure. The diagnostic platform, including GeneXpert Omni® and Xpert Ultra® is in development. There are seven new compounds and eight approved or repurposed antitubercular drugs in advanced phases of clinical trials, while thirteen vaccine candidates are in clinical trials. New diagnostics, anti-tubercular drugs and tubercular vaccines will be needed to achieve the targets set in the End TB strategy. This chapter explores the medicinal chemistry of anti-tubercular agents in various phases of clinical trials. The present chapter also deals with various diagnostic technologies for early detection of tuberculosis, as well as the tubercular vaccines in various phases of clinical trials.

Keywords: Anti-tubercular agents, Delamanid, Diagnostics, TMC207, Tubercular, Tuberculosis vaccines.