Standard therapy for tuberculosis (TB) takes 6–9 months to work in patients with drug-sensitive strains and 18–24 months in drug-resistant disease. A shorter drug regimen is now on the horizon, involving moxifloxacin, pretomanid and pyrazinamide.
This three-drug combination was evaluated in a phase IIb trial involving 207 patients, published in The Lancet
(online, 17 March 2015). It demonstrated good bactericidal activity with just eight weeks of treatment.
The regimen, known as PaMZ, was safe and well tolerated and was equally effective against drug-sensitive and multidrug-resistant TB. Impressively, treatment was associated with a doubling in cure rates compared with standard therapy (as indicated by negative sputum cultures at eight weeks).
PaMZ will now be evaluated in a phase III clinical programme, STAND, funded by the Global Alliance for TB Drug Development.
 Dawson R, Diacon AH, Everitt D et al. Efficiency and safety of the combination of moxifloxacin, pretomanid (PA-824), and pyrazinamide during the first 8 weeks of antituberculosis treatment: a phase 2b, open-label, partly randomised trial in patients with drug-susceptible or drug-resistant pulmonary tuberculosis. The Lancet 2015. doi:10.1016/S0140-6736(14)62002-X.