3 ms·

https://www.nature.com/articles/d41586-019-02464-0 https://www.nature.com/articles/d41586-019-02464-0 is the Nature article for those that don't want to bother

https://www.nature.com/articles/d41586-019-02464-0 https://www.nature.com/articles/d41586-019-02464-0 is the Nature article for those that don't want to bother getting passed the NYT's registration. It's not a drug discovery, it's an FDA approval of a 3 drug combination treatment of existing molecules. It's not a more deadly strain of tuberculosis, per se (to clarify: as in "more virulent", like H5N1 is compared to normally circulating strains of influenza), but it's the "XDR" designation. This is regular tuberculosis that has developed drug resistance to the prior final lines of treatments. edit: pretomanid is the newest and most novel of the 3 drug treatment. The FDA release is useful: https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-resistant-forms-tuberculosis-affects-lungs https://www.fda.gov/news-events/press-announcements/fda-appr...

not_a_cop75 7y ago
True, but the article says deadliest, not deadly. If my sister is the deadliest she's ever been, that doesn't mean she's going to kill me or even that she's even going to try. She might simply be more angry than ever before, and so the likelihood of killing me while still extremely low is higher than previous. Clickbaity, yes. Accurate, hard to say.
- nocman 7y ago
  I think it is fair to say that using the term "deadliest" in this context gives almost everyone the impression that this strain of the disease is indeed deadly (that is to say, that a fair number of people die from it). So if very few people die from this strain (and I don't know the answer to that, but the grandparent comment implies that very few do), then I'd say it is definitely not accurate.
  - UnFleshedOne 7y ago
    Tb in general is surprisingly deadly actually. [0] "The World Health Organization estimates that 1.8 billion people—close to one quarter of the world's population—are infected with Mycobacterium tuberculosis (M.tb), the bacteria that causes TB. Last year, 10 million fell ill from TB and 1.6 million died." ... "There is growing resistance to available drugs, which means the disease is becoming more deadly and difficult to treat. There were 558,000 cases of drug resistant TB last year." [0] - https://www.tballiance.org/why-new-tb-drugs/global-pandemic https://www.tballiance.org/why-new-tb-drugs/global-pandemic EDIT: I say surprisingly, because before recently I was under impression that tb, being bacterial infection, was solved long ago.
    - nocman 7y ago
      Yeah, I knew that TB overall was deadly - but the post I was referring to implied that this particular strain was not deadly. As I said, I don't know if the implication about this strain is correct, but if it is then referring to that strain as "the deadliest strain of Tuberculosis" would be inaccurate.
  - Fomite 7y ago
    TB generally, and XDR TB specifically, are quite dangerous on a global scale. "By the end of 2016, XDR-TB has been reported by 123 WHO Member States. Information from countries with reliable data suggests that about 6.2% of MDR-TB cases worldwide have XDR-TB. In 2016, there were an estimated 490 000 new cases of MDR-TB worldwide. Only a small proportion of the XDR-TB cases among them are detected given that many low and lower middle-income countries still lack sufficient diagnostic capacity to test for resistance to second-line drugs and thus detect XDR-TB." In a study in South Africa, MDR-TB had a case fatality rate of about 9% in HIV- individuals, and 20% in HIV+ individuals.
    - nocman 7y ago
      Yeah, won't repeat it here, but see my response to "UnFleshedOne" in this thread.
whiddershins 7y ago
Hold on, before we get in to a confusing argument of terms, does this strain of tuberculosis have one of highest mortality rates per infection or not? If so, the headline is more or less accurate. If not, please explain.
- deleted 7y ago
  [deleted]
- classichasclass 7y ago
  Apologies for the Elsevier link, but https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(17)30079-6/fulltext https://www.thelancet.com/journals/lanres/article/PIIS2213-2... The report estimates around 40% mortality for MDR-TB and 60% mortality for XDR-TB. This compares with https://www.who.int/gho/tb/epidemic/cases_deaths/en/ https://www.who.int/gho/tb/epidemic/cases_deaths/en/ which gives about ~13% mortality for all TB cases world wide. So, I think the headline is accurate about that. However, we could cure (at least for some definition of "cure") XDR-TB before; it just took an incredible amount of time with some terrible drugs and some individuals still relapsed. Pa could be a game changer, though. I'll give it a "somewhat justifiably clickbaity" rating. ;)
zaroth 7y ago
Pretomanid was approved by the FDA today. Obviously the molecule and treatment protocol has been in design and study for years up to this point, but FDA approval is a reasonable endpoint to celebrate as a "cure being discovered." I suppose you could also argue it's "not a cure" because in the small trail performed it only cures 90%. Finally, I don't know what you're getting at with "not a more deadly strain". XDR TB is "eXtensively Drug Resistant" which makes it also the most fatal form of TB. There are a lot of things which left untreated can kill you. I assume it is normal for fatality rates of a strain of disease to be stated as the post-treatment fatality rate.

not_a_cop75 7y ago

True, but the article says deadliest, not deadly. If my sister is the deadliest she's ever been, that doesn't mean she's going to kill me or even that she's even going to try. She might simply be more angry than ever before, and so the likelihood of killing me while still extremely low is higher than previous. Clickbaity, yes. Accurate, hard to say.

nocman 7y ago
I think it is fair to say that using the term "deadliest" in this context gives almost everyone the impression that this strain of the disease is indeed deadly (that is to say, that a fair number of people die from it). So if very few people die from this strain (and I don't know the answer to that, but the grandparent comment implies that very few do), then I'd say it is definitely not accurate.
- UnFleshedOne 7y ago
  Tb in general is surprisingly deadly actually. [0] "The World Health Organization estimates that 1.8 billion people—close to one quarter of the world's population—are infected with Mycobacterium tuberculosis (M.tb), the bacteria that causes TB. Last year, 10 million fell ill from TB and 1.6 million died." ... "There is growing resistance to available drugs, which means the disease is becoming more deadly and difficult to treat. There were 558,000 cases of drug resistant TB last year." [0] - https://www.tballiance.org/why-new-tb-drugs/global-pandemic https://www.tballiance.org/why-new-tb-drugs/global-pandemic EDIT: I say surprisingly, because before recently I was under impression that tb, being bacterial infection, was solved long ago.
  - nocman 7y ago
    Yeah, I knew that TB overall was deadly - but the post I was referring to implied that this particular strain was not deadly. As I said, I don't know if the implication about this strain is correct, but if it is then referring to that strain as "the deadliest strain of Tuberculosis" would be inaccurate.
- Fomite 7y ago
  TB generally, and XDR TB specifically, are quite dangerous on a global scale. "By the end of 2016, XDR-TB has been reported by 123 WHO Member States. Information from countries with reliable data suggests that about 6.2% of MDR-TB cases worldwide have XDR-TB. In 2016, there were an estimated 490 000 new cases of MDR-TB worldwide. Only a small proportion of the XDR-TB cases among them are detected given that many low and lower middle-income countries still lack sufficient diagnostic capacity to test for resistance to second-line drugs and thus detect XDR-TB." In a study in South Africa, MDR-TB had a case fatality rate of about 9% in HIV- individuals, and 20% in HIV+ individuals.
  - nocman 7y ago
    Yeah, won't repeat it here, but see my response to "UnFleshedOne" in this thread.

whiddershins 7y ago

Hold on, before we get in to a confusing argument of terms, does this strain of tuberculosis have one of highest mortality rates per infection or not? If so, the headline is more or less accurate. If not, please explain.

deleted 7y ago
[deleted]
classichasclass 7y ago
Apologies for the Elsevier link, but https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(17)30079-6/fulltext https://www.thelancet.com/journals/lanres/article/PIIS2213-2... The report estimates around 40% mortality for MDR-TB and 60% mortality for XDR-TB. This compares with https://www.who.int/gho/tb/epidemic/cases_deaths/en/ https://www.who.int/gho/tb/epidemic/cases_deaths/en/ which gives about ~13% mortality for all TB cases world wide. So, I think the headline is accurate about that. However, we could cure (at least for some definition of "cure") XDR-TB before; it just took an incredible amount of time with some terrible drugs and some individuals still relapsed. Pa could be a game changer, though. I'll give it a "somewhat justifiably clickbaity" rating. ;)

zaroth 7y ago

Pretomanid was approved by the FDA today. Obviously the molecule and treatment protocol has been in design and study for years up to this point, but FDA approval is a reasonable endpoint to celebrate as a "cure being discovered." I suppose you could also argue it's "not a cure" because in the small trail performed it only cures 90%. Finally, I don't know what you're getting at with "not a more deadly strain". XDR TB is "eXtensively Drug Resistant" which makes it also the most fatal form of TB. There are a lot of things which left untreated can kill you. I assume it is normal for fatality rates of a strain of disease to be stated as the post-treatment fatality rate.