Pretomanid

(Pretomanid®)

Pretomanid

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Drug updated on 6/10/2024

Dosage FormTablet (oral; 200 mg)
Drug ClassAntimycobacterials
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated as part of a combination regimen with bedaquiline and linezolid for the treatment of adults with pulmonary extensively drug resistant (XDR), treatment-intolerant or nonresponsive multidrug-resistant (MDR) tuberculosis (TB).

Summary
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  • Pretomanid is indicated as part of a combination regimen with bedaquiline and linezolid for the treatment of adults with pulmonary extensively drug-resistant, treatment-intolerant, or non-responsive multidrug-resistant tuberculosis.
  • Four systematic reviews/meta-analyses addressed the use of pretomanid in tuberculosis treatment. The studies suggest that regimens containing pretomanid significantly increase the chance of a favorable outcome in DR-TB patients, showing superior early bactericidal activity and high rates of favorable outcomes.
  • A significant concern raised by these studies about pretomanid is hepatotoxicity, leading to serious adverse events when used in certain combinations. This underscores the need for cautious monitoring during its usage.
  • Frequent linezolid-related toxicity was also reported among patients treated with a specific regimen involving pretomanid, highlighting balanced consideration between efficacy and toxicity while choosing treatments.
  • Compared to other drugs, Pretomanid offers strong bactericidal activity potentially bettering treatment outcomes than some other regimens but carries risks such as hepatotoxicity, requiring careful patient selection and monitoring.
  • While specifics on different population subgroups are not detailed extensively in these studies, it's suggested that patients with highly resistant TB respond well to Pretomanid-based regimens indicating potential benefits, particularly for this subset albeit under careful watch on adverse effects.