Zaragoza will become the global epicenter in the fight against tuberculosis this Tuesday through Thursday, as the annual meeting of the ERA4TB (European Accelerator of Tuberculosis Regimes) consortium takes place. This initiative aims to contribute to the eradication of the disease by 2030, a stated goal of the World Health Organization (WHO). The event will bring together 120 international experts, including prominent figures such as Stewart Cole, former director of the Pasteur Institute, and Marco Cavaleri, director of the Public Health Department of the European Medicines Agency.
The latest advances in the development of innovative therapies to combat the world’s deadliest infectious disease, which causes 1.2 million deaths annually, will be presented at the CaixaForum, the venue in the Aragonese capital. Santiago Ramón-García, an ARAID researcher at the University of Zaragoza and event organizer, reports that a catalog of 11 new drugs is currently being developed, two of which have already completed Phase 1 clinical trials.
GSK, the project’s industrial coordinator, is also participating in the ERA4TB meeting, underscoring the importance of public-private collaboration in the fight against tuberculosis. David Barros-Aguirre, Director of R&D for Medicines for Global Health at GSK, emphasizes: “For our company, participation in this initiative is crucial to showcase the latest scientific advances in the fight against tuberculosis, especially in light of the current resurgence of the disease.”
Eleven new active ingredients in development
“It’s important to understand that many of the tuberculosis drugs used today were developed in the 1940s to 1960s. These products have suboptimal efficacy, are not free from toxicity, and their usefulness is limited by the emergence of resistance,” explains Ramón-García.
In this context, a catalog of 11 drug candidates has been developed, two of which have already completed Phase 1 clinical trials, meaning their safety has been tested in humans. “Our goal is not only to develop the active ingredients, but also to understand how to optimally combine them to increase their efficacy,” emphasizes the ARAID researcher.
The company iM4TB, also part of the ERA4TB consortium, is working on the development of macozinone, a promising drug that could reduce treatment to just one or two injections, eliminating months of oral antibiotic administration. “This would make it easier for patients to adhere to treatment and thus make the fight against this disease more effective,” says Alfonso Mendoza, representative of iM4TB.
AI to predict treatment effectiveness
In addition to new therapies, researchers are working on integrating artificial intelligence to optimize clinical trials and improve biomarkers. In this context, the Carlos III University of Madrid, in collaboration with La Paz Hospital, is developing a clinical trial to implement non-invasive AI-based biomarkers.
These biomarkers make it possible to detect the presence of the tuberculosis bacteria and quantify the disease burden using new imaging techniques. “We are facing a significant advance, because currently we have to wait up to two years to know if the treatment has completely eliminated the tuberculosis bacteria from the body. Currently, we have no way to verify this or to know if the disease is reactivated,” explains Santiago Ferrer Bazaga, a collaborator on the study at the Carlos III University of Madrid.
At the same time, the ARAID Foundation and the University of Zaragoza are presenting a groundbreaking technology that has won the international Quality Innovation Awards. It is a hollow fiber bioreactor (HFS) system that can simulate drug concentrations in a controlled environment and the body’s response to treatments. “Thanks to this innovative technology, the data obtained is integrated into mathematical models to predict the most effective doses recommended in clinical phases. This allows for a reduction in the risks, time, and costs of drug development,” explains Ainhoa Lucía, professor at UNIZAR and co-principal investigator of the ERA4TB project.
The significance of these advances lies in the fact that current TB treatments are lengthy and often difficult to administer, especially in regions with limited health resources such as Southeast Asia and sub-Saharan Africa. Furthermore, the development of drug resistance has increased against existing drugs like bedaquiline has put the scientific community on alert.
Eugene Sun of the US TB Alliance emphasizes the need to continue researching safer and more effective alternatives: “Bedaquiline is the first antibiotic developed after more than 40 years of the same treatment for tuberculosis and plays a key role in the treatment of drug-resistant tuberculosis. However, resistance has already been identified, limiting its usefulness in addition to exhibiting a degree of toxicity.”
