Sorfequiline Shortens TB Treatment Time
- 18 hours ago
- 2 min read
A new antibiotic, sorfequiline (also known as TBAJ-876), a next-generation diarylquinoline, has demonstrated promising results in a Phase II study for treating drug-sensitive tuberculosis (TB). The findings, presented by TB Alliance at the Union World Conference on Lung Health, suggest that sorfequiline could significantly shorten the decades-long standard six-month treatment time for TB. Globally, TB remains a major public-health problem, causing $10.7$ million illnesses and $1.23$ million deaths last year.
The trial evaluated sorfequiline in combination with pretomanid and linezolid, comparing it to the standard four-drug regimen (isoniazid, rifampin, pyrazinamide, and ethambutol, or HRZE) and the existing gold-standard BPaL regimen (bedaquiline, pretomanid, and linezolid). The BPaL regimen, introduced in 2019, previously allowed treatment for most drug-resistant TB to be reduced to six months.
The Phase II NC-009 trial, conducted across 22 sites, including locations in South Africa, the Philippines, Georgia, Tanzania, and Uganda, showed superior performance for sorfequiline. The highest dosage group (100mg sorfequiline) achieved stable sputum conversion (SSC) by week 8 in $59%$ of patients, compared to only $45%$ for both the BPaL group and the standard treatment group. Critically, $64%$ of patients in this group were able to stop treatment at week 15 if they had a negative sputum result at week 8.
Researchers noted that sorfequiline shows stronger action against the deadly bacteria than existing treatments. Furthermore, it appears to have a better safety profile and improved patient tolerance compared to bedaquiline, with lower cardiac toxicity signals. Like bedaquiline, sorfequiline is designed as an oral drug, making the lengthy treatment process easier for patients.
According to Dr. Mel Spigelman, CEO of TB Alliance, this development represents an important milestone toward achieving the goal of an ultra-short regimen capable of treating both drug-sensitive and drug-resistant TB. Dr. Maria Beumont, VP of TB Alliance, suggested a sorfequiline-based regimen could potentially be used universally for anyone testing positive for TB, removing the need to wait for diagnostic classification.
TB Alliance, which brought the BPaL regimen and pretomanid through development, is planning to move sorfequiline onto Phase III trials, with hopes to launch in 2026. The organization is also exploring a long-acting injectable treatment that could reduce treatment time to as little as one month.
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Shortens TB Treatment Time
