Tuberculosis: over 85% cure rate seen in modified BPaL regimen trial

Subject: Science and Technology

Section: Health

Context:

The interim results of a randomised phase-3/4 trial carried out in India to evaluate the safety and effectiveness of an all-oral, short-course treatment using just three drugs for people with pre-XDR TB or treatment intolerant/non-responsive MDR pulmonary TB appears promising.

Details:

The three drugs are bedaquiline, pretomanid and linezolid (BPaL).
The BPaL regimen has been approved by the WHO but yet to be implemented in India.
A person with pre-XDR TB on BPaL regimen will consume over 500 tablets over 26 weeks compared with over 4,300 tablets over 18 months with conventional treatment for drug-resistant TB.
The shorter duration of the BPaL regimen means that people undergoing the treatment cannot miss even one dose.
Few adverse effects are seen in some patients which are- a drop in haemoglobin count and platelets, and neuropathy.
Linezolid causes a drop in haemoglobin count and neuropathy.
India is targeting to reduce TB incidence by 80% and TB deaths by 90% by 2025.

About BPaL:

BPaL is a combination of three newer antibiotics: bedaquiline, pretomanid and linezolid.
Three doses: While two components pretomanid and bedaquiline are novel drugs developed by TB Alliance and Johnson & Johnson. Linezolid is an old generic drug.
The three drugs are approved in India.
Mode of BPaL: It is an oral regimen.
WHO: the WHO has approved regimens containing pretomanid for all forms of drug-resistant TB.

TB burden on India:

India has the world’s highest TB burden: 2.6 million active cases and close to 450,000 deaths each year from the infectious bacterial disease.
Mumbai is often called the capital of drug-resistant TB cases.
It has the largest number of TB patients on the newer short which is injectionless BPaL in India.
TB Alliance: It is the New York-based non-profit that discovers and offers drugs to fight tuberculosis (TB).
XDR-TB: Extensively drug-resistant tuberculosis (XDR-TB) is a rare type of multidrug-resistant tuberculosis (MDR-TB) in which several of the most effective and core anti-TB drugs fail to work against microbial activity.

About Tuberculosis: https://optimizeias.com/the-road-to-ending-tuberculosis/