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An experimental GlaxoSmithKline
vaccine could prevent tuberculosis developing in half of
those who receive it, making it potentially the first new shot
against the global killer in a century, researchers said on
Tuesday.

Given the failure of other candidates in recent years, it
marks a milestone in the fight against TB, although the 54
per cent efficacy rate achieved in adults in a mid-stage clinical
trial is low compared to immunisations for other diseases.

The current vaccine called Bacille Calmette-Guérin (BCG) was
developed in 1921 and is given routinely to babies in countries
with high rates of TB to prevent severe disease.

However, BCG protection wears off in just a few years and it
does nothing to protect against the most common form of TB that
invades the lungs of adults and adolescents, and can be
transmitted through coughing and sneezing.

A more effective vaccine is viewed by experts as key to
controlling TB and fighting the growing scourge of
drug-resistant infection. With TB a major focus for global
health, the United Nations is holding its first ever high-level
meeting on the disease in New York on Wednesday.

GSK’s vaccine is designed to stop latent TB from becoming
active and causing sickness. An estimated 1.7 billion people –
one quarter of the global population – have latent TB infection,
putting them at risk of a disease that killed 1.6 million people
last year.

Results of an ongoing Phase IIb trial of the vaccine – known
as M72/AS01 and developed by GSK in conjunction with Aeras, a
nonprofit TB group backed by the Bill & Melinda Gates Foundation
– were published online by the New England Journal of Medicine.

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After a mean follow-up of 2.3 years, 10 of the 1,786 adults
vaccinated twice developed active pulmonary TB compared with 22
of the 1,787 given two placebo injections. The study was
conducted in Kenya, Zambia and South Africa.

The vaccine did produce more side effects than placebo, with
two-thirds of participants reporting at least one adverse event,
typically injection-site reactions or flu-like symptoms.

Most of the volunteers had received the BCG vaccine and all
were HIV negative. People with HIV are more vulnerable to TB
because their immune systems are weakened.

Areas Chief Executive Jacqui Shea said the results were
“ground-breaking” and showed that more effective TB vaccines
were achievable.

GSK is confident it can do better in future, with larger
trials set to refine the vaccine’s dosing schedule and
potentially target specific groups of patients who are most
likely to benefit.

“It’s the first time we really tested the biological
potential of our vaccine and we think that there is a lot of
additional improvement now that we can bring,” the company’s
head of vaccines research, Emmanuel Hanon, told Reuters.

TB is a particularly tricky disease to vaccinate against
because the bacteria that cause it can hide from the body’s
immune system and scientists lack protective markers in the
blood to predict whether a vaccine will work.

As a result, TB vaccines must be tested in big clinical
trials, a large and costly gamble.

Mike Turner, head of infection and immunobiology at the
Wellcome Trust medial charity, said the encouraging results
represented a “landmark moment” and M72/AS01 now needed to be
tested in much larger numbers of people.

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