Sad day for TB vaccines

Dear all,

yesterday was a sad day for TB vaccines.

The Lancet published the final results of the study in which lots of us hoped for: to prove the efficacy of a new TB vaccine, the highly promising MVA85A, the first one after the BCG (and remember, BCG is  from 1921!).   The MVA85A was originally conceived by researchers from Oxford University (Prof Adrian Hill and Prof Helen McShane et al), and had an extensive previous portfolio of successfulness in efficacy and immunogenicity assays in different animal models and early clinical trials. The Phase IIB trial was possible thanks to Aeras, a nonprofit biotech to develop TB vaccines, The Wellcome Trust, and the Oxford-Emergent Tuberculosis Consortium (OETC) (University of Oxford and Emergent BioSolutions), as well as to the University of Cape Town’s South African Tuberculosis Vaccine Initiative (SATVI), where the trial was conducted.

The clinical trial results demonstrated how MVA85A failed to confer statistically significant protection against TB disease or infection in 2794 southafrican infants who had been vaccinated at birth with BCG. Its effectiveness was of just 17%, obviously non sufficient.

After such a fabulous work it is a pity to have such a results. It is true that this is the outcome of a quite “old” design,  the first in the class. Development of new drugs and the superstrict regulatory requirements might have credit for that, as once the drug is ready, it might be already too old.

Of course the study is still worthy, as said by Dr Mario Raviglione, Director of the World Health Organization (WHO) Stop TB Department:  “This trial also has demonstrated that it is possible to conduct a large efficacy trial among infants in an area with high TB incidence – which will provide the basis for testing other TB vaccine candidates now in the pipeline.”

We do agree, the trial was indeed still worthy. And moreover, this might be the perfect occasion to rethink the natural history of TB. Maybe this will be the time to get  back some “out of the box” theories like the “dynamic hypothesis”, the “citadel paradox” or the “damage theory”  to explain the evolution from latent infection towards active TB. We are all in this ship, but maybe the vaccines are not the solution. Maybe we should build other strategies. So this is the message we’d like to share with  all the TB researchers today:

Failure is always necessary to advance, in everything. So this is the time to continue seeking. Think differently. Try newer things. Do act. 

………………………………………………………………………………………………………………………………………………You can find the manuscript available here

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2 Responses to Sad day for TB vaccines

  1. Gerard Minuesa says:

    A seguir intentant-ho! Ànims!

  2. Pingback: TB and the sad case of Ravindra Patil

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