Innovations to outsmart TB
The only TB vaccine on the market today, the Bacille Calmette-Guerin (BCG) vaccine, was first used how many years ago?
25
75
50
100
The BCG vaccine was first used in 1921, 100 years ago! Since then, there has yet to be any other TB vaccines approved for use, demonstrating both the dearth of and urgent need for research and development (R&D) into additional TB vaccines. While it could be several years until a new vaccine is available, there is reason for hope. Fifteen years ago, there was only one TB vaccine candidate in the clinical pipeline. Now, there are over ten.
The BCG vaccine was first used in 1921, 100 years ago! Since then, there has yet to be any other TB vaccines approved for use, demonstrating both the dearth of and urgent need for research and development (R&D) into additional TB vaccines. While it could be several years until a new vaccine is available, there is reason for hope. Fifteen years ago, there was only one TB vaccine candidate in the clinical pipeline. Now, there are over ten.
TB causes about ____ of all deaths from antimicrobial resistance?
1/5
1/3
1/4
1/2
Antimicrobial resistance (AMR)—which occurs when microorganisms no longer respond to the drugs designed to treat them—is becoming a significant global threat and a challenge that is making TB more deadly and difficult to treat. To stay ahead of this threat, we need both improved treatments for drug-resistant strains as well as shorter, simplified TB treatments regimens to help improve adherence and stem the rise of additional drug-resistant strains.
Antimicrobial resistance (AMR)—which occurs when microorganisms no longer respond to the drugs designed to treat them—is becoming a significant global threat and a challenge that is making TB more deadly and difficult to treat. To stay ahead of this threat, we need both improved treatments for drug-resistant strains as well as shorter, simplified TB treatments regimens to help improve adherence and stem the rise of additional drug-resistant strains.
How many novel TB drugs have been approved by the Food and Drug Administration since 1960?
2
4
3
5
Just two. Bedaquiline, a drug to combat multidrug-resistant TB (MDR-TB) developed by Johnson & Johnson, was approved in 2012, at the time becoming the first new drug approved to treat TB in more than 40 years. In 2019, pretomanid, a new drug to treat highly drug-resistant TB developed by the TB Alliance, was approved as part of a combination regimen with bedaquiline and linezolid. The regimen reduces treatment time from up to two years to just six months and significantly improves treatment outcomes.
Just two. Bedaquiline, a drug to combat multidrug-resistant TB (MDR-TB) developed by Johnson & Johnson, was approved in 2012, at the time becoming the first new drug approved to treat TB in more than 40 years. In 2019, pretomanid, a new drug to treat highly drug-resistant TB developed by the TB Alliance, was approved as part of a combination regimen with bedaquiline and linezolid. The regimen reduces treatment time from up to two years to just six months and significantly improves treatment outcomes.
True or False: Adults living in or traveling to a TB endemic country can visit their doctor to receive a vaccine to protect them against TB.
True
False
Unfortunately, this is not the case. While the BCG vaccine is largely effective at protecting infants and young children from the most serious forms of TB, it has limited effect in preventing pulmonary TB, the most common form in adults. This underscores the urgent need for new vaccines to bring this epidemic under control.
Unfortunately, this is not the case. While the BCG vaccine is largely effective at protecting infants and young children from the most serious forms of TB, it has limited effect in preventing pulmonary TB, the most common form in adults. This underscores the urgent need for new vaccines to bring this epidemic under control.
Today, treatment for drug-resistant TB (DR-TB) can involve taking upwards of how many thousand pills?
400
14,000
4,000
40,000
Treatment for DR-TB is long and complicated. For most patients, today’s DR-TB therapies consist of taking more than 14,000 pills for as long as two years, plus daily injections for six months. As a result, many patients struggle to complete their treatment. The recent regulatory approval of pretomanid, as part of a three-drug treatment regimen, has potential to reduce the length and cost of treatments; however, additional shorter simplified treatments regiments are still needed for both regular TB and DR-TB.
Treatment for DR-TB is long and complicated. For most patients, today’s DR-TB therapies consist of taking more than 14,000 pills for as long as two years, plus daily injections for six months. As a result, many patients struggle to complete their treatment. The recent regulatory approval of pretomanid, as part of a three-drug treatment regimen, has potential to reduce the length and cost of treatments; however, additional shorter simplified treatments regiments are still needed for both regular TB and DR-TB.
How much is the average cost of treating an MDR-TB patient in the United States, factoring in both direct treatment costs and productivity losses?
$193,000
$393,000
$293,000
$493,000
While there are nearly half a million MDR-TB cases each year worldwide, cases in the United States are rarer, about 100 cases annually. However, MDR-TB still exacts a significant financial toll. A single case of MDR-TB on average costs $393,000, including direct treatment costs and productivity losses. For extensively drug-resistant TB, that amount grows to $780,000.
While there are nearly half a million MDR-TB cases each year worldwide, cases in the United States are rarer, about 100 cases annually. However, MDR-TB still exacts a significant financial toll. A single case of MDR-TB on average costs $393,000, including direct treatment costs and productivity losses. For extensively drug-resistant TB, that amount grows to $780,000.
True or False: Instead of taking their TB medicine as pills, children can now receive TB medicine in the form of fruit-flavored tablets that dissolve in water.
True
False
True. Until recently, children diagnosed with TB had to rely on six months of foul-tasting, improperly formulated adult medicines. This all changed with the introduction of child-friendly, fixed-dose treatments. Developed by TB Alliance, these medicines are dissolvable in water, fruit-flavored for palatability, and formulated for correct dosage. Since their launch in 2016, these medicines have been adopted in over 116 countries with enough treatment courses ordered to meet the needs of more than 75 percent of the world’s children reported to have TB.
True. Until recently, children diagnosed with TB had to rely on six months of foul-tasting, improperly formulated adult medicines. This all changed with the introduction of child-friendly, fixed-dose treatments. Developed by TB Alliance, these medicines are dissolvable in water, fruit-flavored for palatability, and formulated for correct dosage. Since their launch in 2016, these medicines have been adopted in over 116 countries with enough treatment courses ordered to meet the needs of more than 75 percent of the world’s children reported to have TB.
Which of the following is NOT a side effect experienced by patients being treated for TB?
Hearing impairment
Vision impairment
Kidney damages
Greenish urine discoloration
Depression/Psychosis
Treatment regimens for TB can be highly toxic and cause serious side effects including depression, psychosis, mobility loss, hearing and vision impairment, kidney damage, and more. While urine discoloration is a side effect of a common TB drug, it causes one’s urine to become reddish or orangish in color, rather than green.
Treatment regimens for TB can be highly toxic and cause serious side effects including depression, psychosis, mobility loss, hearing and vision impairment, kidney damage, and more. While urine discoloration is a side effect of a common TB drug, it causes one’s urine to become reddish or orangish in color, rather than green.
True or False: Not everyone infected with TB bacteria becomes ill. For some people, the bacteria can live dormant in their body without making them sick.
True
False
True. This is known as latent TB infection, and it is quite common. In fact, about one-third of the world’s population is estimated to have latent TB. While many of these people will never develop TB disease, in about 10 percent of cases, the latent infection will eventually become active. This why it is important that individuals with latent TB receive treatment to prevent their infection from becoming active. Thankfully, treating latent TB became easier in 2011 with the introduction of 3HP, a shorter preventative regimen that can be taken weekly, rather than daily.
True. This is known as latent TB infection, and it is quite common. In fact, about one-third of the world’s population is estimated to have latent TB. While many of these people will never develop TB disease, in about 10 percent of cases, the latent infection will eventually become active. This why it is important that individuals with latent TB receive treatment to prevent their infection from becoming active. Thankfully, treating latent TB became easier in 2011 with the introduction of 3HP, a shorter preventative regimen that can be taken weekly, rather than daily.
Which of the following is NOT a commonly used diagnostic method for identifying TB?
Sputum test
Skin test
Urine test
Blood test
Skin tests or blood tests are often used to detect TB bacteria in the body, while examination of sputum by microscopy or sputum tests are widely used to determine whether the infection is active. Scientists are continuing to pursue ways to make TB tests easier, quicker, and less invasive for patients, and one such approach being evaluated is a point-of-care urine-based test to identify active TB that looks and fun
Skin tests or blood tests are often used to detect TB bacteria in the body, while examination of sputum by microscopy or sputum tests are widely used to determine whether the infection is active. Scientists are continuing to pursue ways to make TB tests easier, quicker, and less invasive for patients, and one such approach being evaluated is a point-of-care urine-based test to identify active TB that looks and fun
True or False: Diagnostic tests exist that can not only indicate whether a person has TB, but also whether the bacteria in their body is resistant to specific TB treatments.
True
False
True. This is known as drug susceptibility testing. Historically this has been done by culturing or growing the bacteria in a lab and seeing how it responds to anti-TB drugs, which is a lengthy process that can take up to 50 days. However, new tests are emerging to make this process faster and easier. For example, the Xpert molecular test is a point-of-care automated test than can detect resistance to six common TB drugs in under 90 minutes, and the BD MGIT system is a fully automated, lab-in-a-box system for growing and testing cultures more quickly.
True. This is known as drug susceptibility testing. Historically this has been done by culturing or growing the bacteria in a lab and seeing how it responds to anti-TB drugs, which is a lengthy process that can take up to 50 days. However, new tests are emerging to make this process faster and easier. For example, the Xpert molecular test is a point-of-care automated test than can detect resistance to six common TB drugs in under 90 minutes, and the BD MGIT system is a fully automated, lab-in-a-box system for growing and testing cultures more quickly.
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