Sudapyridine (WX-081) is a new agent being studied for TB with a mechanism of action similar to bedaquiline, functioning as an ATP synthase inhibitor. It could be important for MDR-TB, which remains a major global health challenge. Sudapyridine has the potential to reduce some of the side effects observed with bedaquiline (such as cardiac issues with prolonged QT intervals, or liver toxicity and gastrointestinal issues). It is currently in phase III of development in patients with rifampicin-resistant pulmonary tuberculosis. Primary patents on sudapyridine are present in key countries of manufacture such as India, China and South Africa and are expected to expire in 2035. Secondary patents covering manufacturing processes and intermediates with an expected expiry date in 2037 are present in a few LMICs.

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