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Research Roundup: Paxlovid concerns, new TB drug regimen, COVID-19 booster approvals

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PATH/Manshun Lai

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.

September 6, 2022 by Hannah Sachs-Wetstone

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email.

Experts are increasingly concerned about connections between Paxlovid, Pfizer’s COVID-19 antiviral drug, and COVID rebound in patients who complete the five-day regimen, especially as Paxlovid use has grown dramatically in recent months. The US Food and Drug Administration (FDA) has asked Pfizer to investigate whether a second course will prevent rebound. A large study previously showed that Paxlovid significantly reduced hospitalizations and deaths in those 65 years and older, but uncertainty remains over the drug’s effectiveness in younger people as well as the link between the drug and COVID rebound. Rebound has also been observed in people who have not taken Paxlovid as well.

A new study investigating the effectiveness of the BPaL drug regimen (a combination of bedaquiline, pretomanid, and linezolid) with linezolid at lower doses found that the treatment was still highly effective in patients with drug-resistant tuberculosis (TB) and the number of patients who experienced side effects related to linezolid dropped significantly. BPaL was approved by the FDA in 2019. Although studies showed the drug to be highly effective in drug-resistant TB patients, there was also a high rate of side effects found to be linked to linezolid. The new study, supported by TB Alliance, published in the New England Journal of Medicine indicated that the dosage of linezolid can be halved while maintaining similar efficacy, making the six-month regimen easier and more tolerable for patients.

On Wednesday, August 31, the FDA gave emergency use authorizations to Moderna and Pfizer-BioNTech’s Omicron-updated COVID-19 booster shots to be used as single-dose inoculations at least two months after the first booster vaccination. Both vaccines are aimed at targeting both the original COVID-19 and B.A.4 and B.A.4 Omicron subvariants. Whereas Moderna’s booster is approved for all adults 18 years and older, the Pfizer-BioNTech booster is approved for all people 12 years and older. The CDC endorsed the vaccines on Thursday, clearing the way for a quick rollout in the coming weeks. 
Categories: COVID-19, FDA, Research Roundup, Tuberculosis, Vaccines

About the author

Hannah Sachs-WetstoneGHTC

Hannah supports advocacy and communications activities and member coordination for GHTC. Her role includes developing and disseminating digital communications, tracking member and policy news, engaging coalition members, and organizing meetings and events.Prior to joining GHTC,...read more about this author

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September 12, 2022

Research Roundup: New malaria vaccine, needle-free COVID-19 vaccines, and AI model for TB

Written by Hannah Sachs-Wetstone / GHTC
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Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email.A University of Oxford research team published promising results for a new malaria vaccine, R21. The trial, conducted among 409 children in Burkina Faso, found that an initial three doses followed by a booster after one year showed up to 80 percent efficacy in preventing malaria. The developers say the vaccine can be produced for just a few dollars and that they expect the vaccine to be rolled out next year through a manufacturing deal for more than 100 million doses a year with the Serum Institute of India. The rollout of the vaccine will follow an approval process that hinges on the results from a larger trial, which will be published in the coming months. Both India and China have approved needle-free COVID-19 vaccines­—nasal and inhaled versions, respectively. The nasal version, licensed to Bharat Biotech, was developed by scientists at Washington University in St. Louis. CanSino Biologics has developed the inhaled version, which is a version of their own injected vaccine. Both vaccines use harmless cold viruses although the developers of the nasal version are seeking approval to use the vaccine as a regular and booster dose whereas the inhaled version was only tested as a booster. It is unclear when either vaccine will be available for distribution. These needle-free vaccines are just two of more than ten candidates being studied, as scientists are pursuing needle-free vaccines as a potential strategy to improve protection and make vaccines easier to administer, particularly in low-income countries.A new study published in the journal Radiology looked at Google’s artificial intelligence (AI) model for automating tuberculosis (TB) detection compared to radiologists identifying TB on chest X-rays. The model uses AI to analyze X-ray images to determine which patients should receive follow-up confirmatory molecular testing that is expensive and time-consuming. The AI model could address physician shortages as well as improve TB outcomes and lower costs. While the study revealed promising results across large and diverse patient populations, the model needs to be further tested in real world environments with populations that are older and have more atypical presentations of the disease or other lung abnormalities. A study in a Zambian clinic, which will be finished in the coming months will provide further insight into the potential of the model. 
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August 29, 2022

Research Roundup: African-made malaria drug, monkeypox trials, and Moderna booster request

Written by Hannah Sachs-Wetstone / GHTC
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Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email.The World Health Organization (WHO) awarded the first prequalification to an African-manufactured antimalarial drug used to prevention infection in pregnant women and infants. The medicine, sulfadoxine-pyrimethamine, marketed as Wiwal, is made by Kenyan drug company Universal Corporation Limited. The approval is a step toward strengthening local production of medicines, as well as addressing the disproportionate burden of malaria in Africa.An Oxford University research team announced their new PLATINUM trial assessing whether SIGA Technologies’ tecovirimat (Tpoxx) is an effective treatment for monkeypox. The study seeks to recruit at least 500 participants, who will be given a 14-day treatment of two doses daily or a placebo. Tpoxx has been cleared by the United Kingdom and European Union to treat diseases caused by the family of orthopoxvirus that includes smallpox and monkeypox based on studies in animals and healthy humans, though it has only been used in severe cases in Great Britain. In the United States and Canada, the drug has only been approved to treat smallpox. There have been no studies assessing the effectiveness of the drug in hastening recovery in those infected with monkeypox.Moderna announced that it has requested emergency approval from the US Food and Drug Administration (FDA) for its variant-updated COVID-19 vaccine. The vaccine is a booster dose for adults 18 years and older targeting Omicron subvariants B.A.4 and B.A.5. If approved, doses could be ready to ship in September. Moderna’s announcement follows Pfizer and BioNTech’s news that they have applied for FDA approval for their updated booster.