Companies work together on TB drugs

For the first time in more than 40 years, several promising tuberculosis drugs are in the pipeline — thanks to an influx of money from the Bill & Melinda Gates Foundation and others. But speeding those drugs to the people who need them will require unprecedented cooperation among drug companies, say TB experts meeting in Seattle this week.

Because the bacteria that cause the deadly lung infection quickly evolve to dodge drugs, standard TB treatments hit the bug with several medications at once, said Dr. Tachi Yamada, chief of global health for the Gates Foundation. That means companies that normally compete will have to work together so their drugs can be tested in combination.

"What's needed is a new regimen of three to four drugs ... that's more efficient and efficacious," Yamada said.

Bill Gates met personally with the chief executives of more than a dozen drug companies in March to ask for their cooperation. The foundation also weighed in at a recent Food and Drug Administration (FDA) advisory-committee meeting to urge changes to rules that require drugs be tested one at a time.

"The Gates Foundation is ... using their clout and resources to really make it known this is important to them," said Dr. Mel Spigelman, president of the Gates-funded Global Alliance for TB Drug Development (TB Alliance).

Several drug-company officials are among the 250 experts from 25 nations participating in the Pacific Health Summit, focused on the growing problem of drug-resistant tuberculosis. Many companies are already working with the TB Alliance to test candidate drugs.

The Johnson & Johnson subsidiary Tibotec announced Wednesday it will give the TB Alliance a royalty-free license to a new drug that worked well in early trials in people with resistant disease.

Drugmaker Sanofi-Aventis will allow its most promising drug to be tested in combination with drugs from other companies, said Dr. Robert Sebagg, vice president of Access to Medicines at the French company.

"It's not common to do this in the pharmaceutical industry," Sebagg said. "But it's very important."

Still, more collaborations and money are needed, Spigelman said. "Even with the resources pharma has brought to bear, we're still at the level of a drop in the bucket."

Tuberculosis is a top killer, claiming nearly 2 million lives a year and infecting a third of the world's people. The standard treatment regimen requires patients to swallow pills every day for up to six months. When people stop taking medication too soon, infections can become resistant to multiple drugs.

That's why the number of multidrug-resistant cases has swelled to nearly half a million a year.

Though largely a problem of the developing world, tuberculosis spreads easily.

An estimated 100,000 people in King County carry latent TB bacteria. Last year, 120 active cases were reported.

Four new drugs have shown promising results in early tests, and five more are in earlier stages of development, said Dr. Peter Small, TB manager for the Gates Foundation. "We're looking at an onslaught of innovation."

Small estimates testing drugs in combination instead of singly could cut five to 10 years off development time.

Sandi Doughton: 206-464-2491 or sdoughton@seattletimes.com

Information in this article, published June 18, 2009, was corrected June 18, 2009. The previous story stated that Tibotec announced Wednesday it will give the TB Alliance a free license. Tibotec will give TB Alliance a royalty-free license.