An update on the use of rifapentine for tuberculosis therapy

Introduction: Tuberculosis remains rampant throughout the world, in large part due to the lengthy treatment times of current therapeutic options. Rifapentine, a rifamycin antibiotic, is currently approved for intermittent dosing in the treatment of tuberculosis. Recent animal studies have shown that more frequent administration of rifapentine could shorten treatment times, for both latent and active tuberculosis infection. However, these results were not replicated in a subsequent human clinical trial.

Areas covered: This review analyses the evidence for more frequent administration of rifapentine and the reasons for the apparent lack of efficacy in shortening treatment times in human patients. Inhaled delivery is discussed as a potential option to achieve the therapeutic effect of rifapentine by overcoming the barriers associated with oral administration of this drug. Potential options for developing an inhalable form of rifapentine are also presented.

Expert opinion: Rifapentine is a promising active pharmaceutical ingredient with potential to accelerate treatment of tuberculosis if delivered by inhaled administration. Progression of current fundamental work on inhaled anti-tubercular therapies to human clinical trials is essential for determining their role in future treatment regimens. Whilst the ultimate goal for global tuberculosis control is a vaccine, a short and effective treatment option is equally crucial.