Lamprene (clofazimine) / Novartis - LARVOL DELTA

Clinical evaluation of a commercial culture-free targeted next-generation sequencing test for diagnosis of drug-resistant tuberculosis. (PubMed, Microbiol Spectr) - P=N/A | "The ABL tNGS workflow showed ≥95% sensitivity for rifampicin, isoniazid, and levofloxacin; 92%-93% for pyrazinamide and moxifloxacin; 88% for ethambutol; and 72%-82% for bedaquiline and clofazimine. Further refinement in sample preparation may expand its use to specimens with lower bacterial counts. This study is registered with ClinicalTrials.gov as NCT04239326."

Journal • Next-generation sequencing • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

P027 A case of cutaneous nodules in a migrant man. (PubMed, Br J Dermatol) - "The infectious disease team treated him for multibacillary leprosy with dapsone, rifampicin, clofazimine and steroids. Leprosy is a neglected tropical disease that is under-recognized in Europe, resulting in treatment delay. This is a unique case of leprosy in Ireland, which demonstrates the utility of cutaneous findings and skin biopsy in attaining a diagnosis."

Journal • Hepatitis B • Hepatitis C • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pain • Sarcoidosis • CRP

P030 From nerve to nodules: the unexpected progression of pure neuritic leprosy to lepromatous leprosy with erythema nodosum leprosum. (PubMed, Br J Dermatol) - "The patient was started on World Health Organization-recommended multidrug therapy with rifampicin, dapsone and clofazimine for 12 months...The patient was started on a regimen of monthly pulsed rifampicin, minocycline and moxifloxacin for 12 months. Thalidomide was started to manage the severe ENL reaction...Only one such case has been previously reported. This emphasizes the need for early diagnosis, vigilant follow-up and awareness of potential disease transformations, particularly in endemic areas."

Journal • Dermatology • Immune Modulation • Immunology • Infectious Disease • Muscular Atrophy • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pain

Extensively Drug-Resistant Tuberculosis with Conflicting Resistance Testing Results, Lesotho. (PubMed, Emerg Infect Dis) - "A patient with extensively drug-resistant tuberculosis in Lesotho recovered successfully after failed treatment with bedaquiline, delamanid, linezolid, and clofazimine. Whole-genome sequencing and broth microdilution testing results were not in agreement, illustrating the urgent need for studies that correlate phenotypic and genotypic resistance testing with clinical response."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

NQR as a target for new antibiotics. (PubMed, Front Microbiol) - "Our recent work revealed that clofazimine, and FDA-approved orphan drug, is as a potent NQR inhibitor with strong antivirulence properties. This review highlights the role and significance of NQR and its inhibitors, with an emphasis on the potential development of antibiotics to target this respiratory enzyme."

Journal • Review • Cholera • Infectious Disease

Direct targeted next-generation sequencing for diagnosis of drug-resistant tuberculosis from clinical samples - An update. (PubMed, Indian J Tuberc) - "For respiratory samples with rifampicin resistance, tNGS could be used for the rapid detection of additional drug resistance including newer and repurposed drugs like Bedaquiline, Delamanid, Pretomanid, Linezolid and Clofazimine for which no rapid molecular tests are currently available. tNGS could be performed using different platforms like Illumina, Oxford Nanopore Technology and/or Ion torrent and diverse bio-informatic pipeline options. Positioning of a tNGS with portability system in the current TB diagnostic algorithm and its use in the clinical management of patients' needs further evaluation and efforts."

Biomarker • Journal • Next-generation sequencing • Review • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Whole genome sequencing-based detection of extensively drug-resistant tuberculosis from Ethiopia. (PubMed, Commun Med (Lond)) - "Whole-genome sequencing identifies dominant mutations in genes such as gyrA, atpE, and Rv067 that are associated with resistance to second-line anti-tuberculosis drugs. Significant cross-resistance is observed between key second-line drugs, bedaquiline and clofazimine, as well as delamanid and pretomanid. This finding highlights the need for routine genomic surveillance to detect drug resistance early, improve treatment outcomes, and prevent transmission."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Enhanced activity of apramycin and apramycin-based combinations against Mycobacteroides abscessus. (PubMed, J Antimicrob Chemother) - "Apramycin exhibits more potent in vitro activity against a diverse set of M. abscessus and other rapidly growing mycobacteria than currently recommended aminoglycosides."

Journal • Infectious Disease • Nontuberculous Mycobacterial Disease • Otorhinolaryngology

Management of non-tuberculous mycobacterial pulmonary disease (NTM-PD): a European wide NTM-NET survey (BTS WM 2025) - "The most frequently used were amikacin (100%), tigecycline (61%) and imipenem (50%). Second-line agents including nebulised amikacin, linezolid and clofazimine were used by 68%(n=23), 74%(n=25) and 76%(n=26) respondents, respectively...Ten (29%) centres prescribed Bedaquiline for NTM-PD...Use of injectable and second-line therapy is increasing with limited international/national guidance available. Ensuring access to evidence-based guidelines incorporating these anti-microbials and expert advisory groups is essential to ensure consistent, high-quality NTM-PD care."

Nontuberculous mycobacteria • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases

Clofazimine Treatment Modulates Key Non-Coding RNAs Associated with Tumor Progression and Drug Resistance in Lethal Prostate Cancer. (PubMed, Int J Mol Sci) - "Bulk and single-cell RNAseq followed by functional validation and in silico analysis showed that CLF treatment is associated with apoptosis, ER stress, oxidative phosphorylation, and mitochondrial dysfunction. Most importantly, CLF modulates the expression of several non-coding RNAs, including MALAT1 and NEAT1, that are linked to tumor cell proliferation, cell migration, and drug resistance."

Journal • Castration-Resistant Prostate Cancer • Chronic Myeloid Leukemia • Genito-urinary Cancer • Hematological Malignancies • Leukemia • Metabolic Disorders • Multiple Myeloma • Oncology • Prostate Cancer • Solid Tumor • MALAT1 • NEAT1

Fulminant hepatitis during treatment for per-extensively drug-resistant tuberculosis: A case report and call for improved patient monitoring. (PubMed, Medicine (Baltimore)) - "This case report highlights the importance of regular liver function monitoring during antituberculosis therapy to ensure patient safety."

Journal • Hepatology • Infectious Disease • Inflammation • Liver Failure • Pulmonary Disease • Respiratory Diseases • Tuberculosis

A 6 to 9-month oral regimen for rifampicin-resistant tuberculosis: a randomised open-label non-inferiority trial in China. (PubMed, Clin Microbiol Infect) - "The all-oral regimen was non-inferior to the 9-month injectable-containing regimen, offering an alternative for patients lacking access to bedaquiline, delamanid or pretomanid. However, its efficacy against the latest WHO-recommended bedaquiline-containing regimens requires further validation."

Head-to-Head • Journal • Hepatology • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Clinical translation of photoacoustic imaging using exogenous molecular contrast agents [Invited]. (PubMed, Biomed Opt Express) - "To accelerate clinical adoption, many studies have focused on repurposing FDA-approved agents such as indocyanine green, methylene blue, and clofazimine, which offer favorable optical properties and known safety profiles...Progress in transcranial PAI and molecular probe design continues to broaden its capabilities. Together, these developments underscore the expanding clinical utility of contrast-enhanced PAI for real-time, functional, and molecular imaging."

Journal • Review • Brain Cancer • Oncology • Solid Tumor

Widespread genomic heterogeneity at the type II NAD(P)H dehydrogenase locus predisposes Cryptosporidium to clofazimine resistance. (PubMed, bioRxiv) - "Through genomic analyses we uncovered heterogeneity at the NDH2 locus for C. parvum and C. hominis and widespread carriage of a conserved attenuated allele across multiple continents. This heterogeneity allows parasites genomically linked through frequent sexual recombination to adjust to changing NDH2 requirements and predisposes Cryptosporidium to evade clofazimine treatment."

Heterogeneity • Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Efficacies of sequenced monotherapies of Mycobacterium avium lung infection in mouse. (PubMed, bioRxiv) - "Mice were treated with either the standard triple-drug regimen of clarithromycin, ethambutol, and rifampicin or with sequential monotherapy: clarithromycin, bedaquiline, and clofazimine, with only one drug administered at a time for four-week intervals. These findings provide the first experimental evidence that sequential monotherapy can deliver efficacy comparable to multidrug therapy for M. avium disease without promoting resistance. This proof-of-concept supports further investigation of sequencing strategies as a potentially more tolerable alternative to current regimens."

Journal • Preclinical • Infectious Disease • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

WITHDRAWN Evaluating lineage specific response to tuberculosis treatment regimens using clinical Mycobacterium tuberculosis Complex Isolates (ASTMH 2025) - "The IC50 of first line drugs like rifampicin varied up to 4fold between Mtb lineage 4 and Maf lineage 6...Trial1 (bedaquiline, linezolid, rifapentine) and Trial2 (bedaquiline, clofazimine, moxifloxacin) were most effective against Mtb lineage 2, while SimpliciTB (bedaquiline, pretomanid, moxifloxacin, pyrazinamide) and Trial1 showed superior activity against Mtb lineage 4...MTBC lineage diversity significantly impacts regimen efficacy. Trial1 and End TB showed enhanced activity against specific lineages, underscoring the potential of lineage-tailored treatments to shorten therapy and improve TB control."

Clinical • Infectious Disease • Respiratory Diseases • Tuberculosis

Successful treatment of macrolide-resistant Mycobacterium abscessus infection using multi-drug regimens including dual β-lactams and phage therapy: case reports in two children. (PubMed, ASM Case Rep) - "Here we report two children with macrolide-resistant M. abscessus infections who achieved clinical remission and microbiologic clearance using multi-drug treatment regimens including clofazimine, bedaquiline, linezolid or eravacycline, dual β-lactam therapy with meropenem and amoxicillin, and, in one case, phage therapy. Successful treatment of macrolide-resistant M. abscessus infections in children can be achieved using multi-drug regimens including novel dual β-lactam combinations and phage therapy. Dose adjustment with therapeutic drug monitoring can ameliorate some drug-induced toxicities in children."

Journal • Infectious Disease • Pediatrics

MPHAGE-2025-01: Bacteriophage Therapy for Mycobacterium Abscessus Pulmonary Infection (clinicaltrials.gov) - P1 | N=1 | Enrolling by invitation | Sponsor: Vancouver Coastal Health

New P1 trial • Infectious Disease • Nontuberculous Mycobacterial Disease • Pneumonia • Respiratory Diseases

Cardiac Risk Factors in Drug-Resistant Tuberculosis Patients on Bedaquiline: A Retrospective Cohort Study. (PubMed, Cardiology) - "QT interval prolongation is common in patients with DR-TB treated with Bedaquiline-containing regimens, but the incidence of discontinuation is low. The concomitant use of Clofazimine and the occurrence of hypokalemia during treatment will increase the risk of adverse cardiac events. It is recommended routine electrolyte monitoring, aggressive potassium supplementation, and cautious co-prescription of clofazimine or other QT-prolonging drugs for DR-TB patients on bedaquiline."

Journal • Retrospective data • Cardiovascular • Congestive Heart Failure • Heart Failure • Human Immunodeficiency Virus • Infectious Disease • Pediatrics • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Comparing end-user diagnostic outputs from a commercial tNGS pipeline for Mycobacterium tuberculosis drug resistance detection. (PubMed, IJTLD Open) - "Comparison of the updated pipeline to the original pipeline revealed significant improvements in diagnostic performance, demonstrating that bioinformatic enhancements alone - without wet-lab modifications - can substantially boost sensitivity and diagnostic yield for DR-TB. These findings underscore the critical role of continuous pipeline optimisation in the evolving resistance landscape to enhance real-time clinical decision-making."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Coinfection of Pulmonary Tuberculosis and Borderline Lepromatous Hansen's Disease: A Case Report (APSR 2025) - "Anti-tuberculosis treatment was administered according to WHO guidelines (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol, Clofazimine, and Dapsone). Discussion : This case illustrates the importance of considering TB and HD coinfection in endemic settings. Early recognition and integrated treatment are crucial for optimal outcomes."

Case report • Clinical • Candidiasis • Chronic Cough • CNS Disorders • Cough • Diabetes • Infectious Disease • Metabolic Disorders • Respiratory Diseases • Tuberculosis • Type 2 Diabetes Mellitus

ICoN-1 Phase 3 Study of the Efficacy and Safety of Treatment With MNKD-101, Clofazimine Inhalation Suspension (clinicaltrials.gov) - P3 | N=132 | Terminated | Sponsor: Mannkind Corporation | N=234 ➔ 132 | Trial completion date: Dec 2028 ➔ Nov 2025 | Recruiting ➔ Terminated | Trial primary completion date: Aug 2026 ➔ Nov 2025; Futility

Enrollment change • Trial completion date • Trial primary completion date • Trial termination • Infectious Disease • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases

The curious constraints on clofazimine. (PubMed, J Antimicrob Chemother) - "Policy options include simplified access pathways, WHO-based procurement for leprosy, and public manufacturing to stabilize supply. Clofazimine's case illustrates the need for proactive stewardship and access models that align with public health goals."

Journal • Infectious Disease • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

A comparative study on stevioside- and rubusoside-assisted micellar solubilization of clofazimine for physicochemical and in vitro release properties. (PubMed, Int J Pharm X) - "These results suggest that RUB's amphiphilic structure facilitates stable micelle formation and efficient drug loading. Overall, RUB presents a promising natural solubilizer and oral delivery vehicle for lipophilic bioactives in food and pharmaceutical applications, providing new insights into the structure-function roles of steviol glycosides."

Journal • Preclinical

Enhanced antimycobacterial efficacy of simulated inhaled clofazimine versus oral clofazimine in combination with azithromycin and ethambutol in a hollow-fiber system. (PubMed, J Antimicrob Chemother) - "Inhalation of clofazimine with an azithromycin-ethambutol backbone increases treatment efficacy and decreases the development of macrolide resistance compared to oral administration in a hollow-fiber system. This calls for a clinical trial of inhaled clofazimine."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases