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AMR Drug RepurposingSmart Screeningresearch prototype

Pretomanid

FDA-approved product (tablet, oral), marketed as Pretomanid.

Registered studies
49
Lab records
57
Pathogens at ≥40%
1 of 4

Chemical structure

Chemical structure of Pretomanid
A drawing shows what the molecule is, not what it does.

Existing / approved use

Documented · FDA, WHO, ChEMBL

Approved for

  • Drug-resistant tuberculosis
  • Multidrug-resistant tuberculosis
  • Pulmonary tuberculosis
  • Tuberculosis

Indications ChEMBL records as approved, from FDA and DailyMed labels. Label ↗

WHO therapeutic group
Other drugs for treatment of tuberculosis
FDA pharmacologic class
Antimycobacterial FDA label ↗
Anti-infective classification
Classified as an existing antimicrobial.WHO ATC J04AK08; FDA class Antimycobacterial

Repurposing investigation

Pretomanid is already an antimicrobial, so it is not counted among the repurposing candidates. Its AI-predicted activity is shown below for reference.

AI-predicted activity

AI prediction · nothing measured
  • MRSA39.0% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates.
  • E. coli34.1% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates.
  • K. pneumoniae30.9% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates.
  • M. tuberculosis98.0% AI-predicted activityAt or above the ≥40% mark this site uses to surface candidates. This medicine was in the model's training data, so this is recall, not a new prediction.

A model’s estimate of laboratory activity against each pathogen species. It is not clinical effectiveness.

Evidence

Clinical and experimental

Documented evidence

Clinical

49registered studies name this medicine, for any condition. See them below.

Experimental

  • M. tuberculosis: measured active in 52 of 57 lab records
Open Pretomanid in ChEMBL Registered studies below
Show the 57 laboratory records, with sources

Loading records…

“Active” means the measured value reached this project’s laboratory cutoff (10 µM or stronger). A laboratory result does not show an effect in patients.

Docking

Computational · nothing measured

Dihydrofolate reductase ↗ (E. coli)

-9.3 kcal/mol

0better fit →-12

KPC-2 carbapenemase ↗ (K. pneumoniae)

-8.0 kcal/mol

0better fit →-12

Enoyl-ACP reductase (InhA) ↗ (M. tuberculosis)

-8.9 kcal/mol

0better fit →-12

Dihydrofolate reductase ↗ (MRSA)

-7.7 kcal/mol

0better fit →-12

AutoDock Vina, one experimentally solved protein per pathogen. This project’s screening target is -7.0 kcal/mol, its own mark rather than a universal cutoff. A docking score is a structural hypothesis, not proof of binding, and requires experimental validation.

Other medicines to investigate

AI prediction · nothing measured

Other repurposing candidates: approved medicines besides Pretomanid with AI-predicted activity ≥40% against the chosen pathogen, leaving out existing antimicrobials. They are computational candidates for further investigation, not alternatives and not recommendations.

Sorted by AI-predicted activity, high to low. The order is not a ranking of which medicine is better.

Registered studies

A registration describes a study; it does not establish a positive result.

  • Various Doses and Durations of Linezolid Plus Bedaquiline & Pretomanid in Participants With Drug Resistant Tuberculosis

    NCT03086486 · start 2017-11-21

    Registered record
    Registry ID
    NCT03086486
    Conditions
    Tuberculosis, Pulmonary; Tuberculosis, Multidrug-Resistant; Tuberculosis, MDR; Tuberculosis; Extensively Drug-Resistant Tuberculosis; Pre-XDR-TB; XDR-TB
    Interventions
    Pretomanid; Linezolid; Bedaquiline; Placebo Linezolid
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Completed
    Start
    2017-11-21
    Completion
    2022-02-08
    Enrolment
    181

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTuberculosis, Pulmonary; Tuberculosis, Multidrug-Resistant; Tuberculosis, MDR; Tuberculosis +3 more
    InterventionPretomanid; Linezolid; Bedaquiline; Placebo Linezolid
    PhasePhase 3
    Registry statusCompleted

  • The Individualized M(X) Drug-resistant TB Treatment Strategy Study

    NCT03237182 · start 2017-06-14

    Registered record
    Registry ID
    NCT03237182
    Conditions
    Tuberculosis, Multidrug-Resistant
    Interventions
    Individualized TB treatment with multiple drugs; Standardized TB treatment with multiple drugs
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Terminated
    Start
    2017-06-14
    Completion
    2022-12-19
    Enrolment
    205

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTuberculosis, Multidrug-Resistant
    InterventionIndividualized TB treatment with multiple drugs; Standardized TB treatment with multiple drugs
    PhasePhase 4
    Registry statusTerminated

  • Pragmatic Clinical Trial for a More Effective Concise and Less Toxic MDR-TB Treatment Regimen(s)

    NCT02589782 · start 2017-01

    Registered record
    Registry ID
    NCT02589782
    Conditions
    Tuberculosis, Multidrug-Resistant; Extensively Drug-Resistant Tuberculosis; Tuberculosis, Pulmonary
    Interventions
    Bedaquiline; Pretomanid; Moxifloxacin; Linezolid; Clofazimine; Locally accepted standard of care which is consistent with the WHO recommendations for the treatment of M/XDR-TB.
    Study type
    INTERVENTIONAL
    Phase
    Phase 2 / Phase 3
    Registry status
    Completed
    Start
    2017-01
    Completion
    2022-08-05
    Enrolment
    552

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTuberculosis, Multidrug-Resistant; Extensively Drug-Resistant Tuberculosis; Tuberculosis, Pulmonary
    InterventionBedaquiline; Pretomanid; Moxifloxacin; Linezolid +2 more
    PhasePhase 2 / Phase 3
    Registry statusCompleted

  • Assessing PA-824 for Tuberculosis (the APT Trial)

    NCT02256696 · start 2015-04-29

    Registered record
    Registry ID
    NCT02256696
    Conditions
    Pulmonary Tuberculosis
    Interventions
    PA-824; Rifampin; Rifabutin; Pyrazinamide; Ethambutol; Isoniazid
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Completed
    Start
    2015-04-29
    Completion
    2022-05-01
    Enrolment
    157

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionPulmonary Tuberculosis
    InterventionPA-824; Rifampin; Rifabutin; Pyrazinamide +2 more
    PhasePhase 2
    Registry statusCompleted

  • A Phase 3 Trial Assessing Safety and Efficacy of B-Pa-L in Participants With DR-TB

    NCT02333799 · start 2015-03

    Registered record
    Registry ID
    NCT02333799
    Conditions
    Pulmonary Tuberculosis
    Interventions
    Bedaquiline; PA-824; Linezolid
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Completed
    Start
    2015-03
    Completion
    2020-08-03
    Enrolment
    109

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionPulmonary Tuberculosis
    InterventionBedaquiline; PA-824; Linezolid
    PhasePhase 3
    Registry statusCompleted

  • Shortening Treatment by Advancing Novel Drugs

    NCT02342886 · start 2015-02

    Registered record
    Registry ID
    NCT02342886
    Conditions
    Tuberculosis, Pulmonary, Drug Sensitive; Tuberculosis, Pulmonary, Multi Drug-resistant
    Interventions
    Moxifloxacin; PA-824; Pyrazinamide; HRZE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol combination); HR (rifampicin plus isoniazid combination tablets)
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Completed
    Start
    2015-02
    Completion
    2018-05
    Enrolment
    284

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTuberculosis, Pulmonary, Drug Sensitive; Tuberculosis, Pulmonary, Multi Drug-resistant
    InterventionMoxifloxacin; PA-824; Pyrazinamide; HRZE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol combination) +1 more
    PhasePhase 3
    Registry statusCompleted

  • A Phase 2 to Evaluate the Efficacy, Safety and Tolerability of Combinations of Bedaquiline, Moxifloxacin, PA-824 and Pyrazinamide in Adult Subjects With Drug-Sensitive or Multi Drug-Resistant Pulmonary Tuberculosis.

    NCT02193776 · start 2014-10-23

    Registered record
    Registry ID
    NCT02193776
    Conditions
    Tuberculosis
    Interventions
    PA-824; bedaquiline; moxifloxacin; pyrazinamide; isoniazid, rifampicin, pyrazinamide and ethambutol combination tablet
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Completed
    Start
    2014-10-23
    Completion
    2018-02-07
    Enrolment
    240

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTuberculosis
    InterventionPA-824; bedaquiline; moxifloxacin; pyrazinamide +1 more
    PhasePhase 2
    Registry statusCompleted

  • Evaluation of Early Bactericidal Activity in Pulmonary Tuberculosis With Clofazimine (C)-TMC207 (J)-PA-824 (Pa)-Pyrazinamide (Z)

    NCT01691534 · start 2012-10

    Registered record
    Registry ID
    NCT01691534
    Conditions
    Pulmonary Tuberculosis
    Interventions
    TMC207 (J); PA-824 (PA); pyrazinamide (Z); clofazimine (C); Rifafour
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Completed
    Start
    2012-10
    Completion
    2013-05
    Enrolment
    105

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionPulmonary Tuberculosis
    InterventionTMC207 (J); PA-824 (PA); pyrazinamide (Z); clofazimine (C) +1 more
    PhasePhase 2
    Registry statusCompleted

  • Effect of PA-824 and of PA-824 Plus Moxifloxacin on the QTc Interval in Healthy Volunteers

    NCT01674218 · start 2012-09

    Registered record
    Registry ID
    NCT01674218
    Conditions
    Tuberculosis
    Interventions
    Moxifloxacin; PA-824; Placebo
    Study type
    INTERVENTIONAL
    Phase
    Phase 1
    Registry status
    Completed
    Start
    2012-09
    Completion
    2012-12
    Enrolment
    74

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTuberculosis
    InterventionMoxifloxacin; PA-824; Placebo
    PhasePhase 1
    Registry statusCompleted

  • Evaluating the Safety and Drug Interaction of PA-824, an Investigational Tuberculosis Medication, Together With Efavirenz, Ritonavir-Boosted Lopinavir, or Rifampin

    NCT01571414 · start 2012-05

    Registered record
    Registry ID
    NCT01571414
    Conditions
    Tuberculosis
    Interventions
    PA-824; Efavirenz (EFV); Lopinavir/Ritonavir (LPV/r); Rifampin (RIF)
    Study type
    INTERVENTIONAL
    Phase
    Phase 1
    Registry status
    Completed
    Start
    2012-05
    Completion
    2013-05
    Enrolment
    52

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTuberculosis
    InterventionPA-824; Efavirenz (EFV); Lopinavir/Ritonavir (LPV/r); Rifampin (RIF)
    PhasePhase 1
    Registry statusCompleted

  • Evaluation of 8 Weeks of Treatment With the Combination of Moxifloxacin, PA-824 and Pyrazinamide in Patients With Drug Sensitive and Multi Drug-Resistant Pulmonary Tuberculosis (TB) (NC-002)

    NCT01498419 · start 2012-03

    Registered record
    Registry ID
    NCT01498419
    Conditions
    Pulmonary Tuberculosis
    Interventions
    Moxifloxacin (M); Pretomid (Pa); Pyrazinamide (Z); Rifafour
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Completed
    Start
    2012-03
    Completion
    2013-07
    Enrolment
    207

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionPulmonary Tuberculosis
    InterventionMoxifloxacin (M); Pretomid (Pa); Pyrazinamide (Z); Rifafour
    PhasePhase 2
    Registry statusCompleted

  • Evaluation of Early Bactericidal Activity in Pulmonary Tuberculosis With(J-M-Pa-Z) (NC-001)

    NCT01215851 · start 2010-10

    Registered record
    Registry ID
    NCT01215851
    Conditions
    Pulmonary Tuberculosis
    Interventions
    PA-824; Pyrazinamide; TMC207; Rifafour; Moxifloxacin
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Completed
    Start
    2010-10
    Completion
    2011-08
    Enrolment
    85

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionPulmonary Tuberculosis
    InterventionPA-824; Pyrazinamide; TMC207; Rifafour +1 more
    PhasePhase 2
    Registry statusCompleted

  • Evaluation of the Pharmacokinetic Interaction Between PA-824 and Midazolam

    NCT01768273 · start 2009-12

    Registered record
    Registry ID
    NCT01768273
    Conditions
    Tuberculosis
    Interventions
    Midazolam; PA-824
    Study type
    INTERVENTIONAL
    Phase
    Phase 1
    Registry status
    Completed
    Start
    2009-12
    Completion
    2010-04
    Enrolment
    14

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTuberculosis
    InterventionMidazolam; PA-824
    PhasePhase 1
    Registry statusCompleted

  • Food Effect Study on the Bioavailability and PK of PA-824 Tablets in Healthy Adult Subjects (CL-009)

    NCT01830439 · start 2009-09

    Registered record
    Registry ID
    NCT01830439
    Conditions
    Tuberculosis
    Interventions
    PA-824 200mg; PA-824 50mg
    Study type
    INTERVENTIONAL
    Phase
    Phase 1
    Registry status
    Completed
    Start
    2009-09
    Completion
    2010-01
    Enrolment
    32

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionTuberculosis
    InterventionPA-824 200mg; PA-824 50mg
    PhasePhase 1
    Registry statusCompleted

  • Evaluation of Early Bactericidal Activity in Pulmonary Tuberculosis (CL-010)

    NCT00944021 · start 2009-08

    Registered record
    Registry ID
    NCT00944021
    Conditions
    Pulmonary Tuberculosis
    Interventions
    PA-824; PA-824; PA-824; Rifafour e-275 mg; PA-824
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Completed
    Start
    2009-08
    Completion
    2010-05
    Enrolment
    69

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionPulmonary Tuberculosis
    InterventionPA-824; PA-824; PA-824; Rifafour e-275 mg +1 more
    PhasePhase 2
    Registry statusCompleted