BPaL regimen can cut time for treatment of drug-resistant TB | India News

NEW DELHI: Even as Covid-19 has disrupted screening and treatment of tuberculosis derailing efforts to eliminate it, the BPaL regimen to reduce treatment time from 18 months to 6 months and reported success rate of 90% can be crucial in the fight against TB.
BPaL is a six-month, alloral, three-drug regimen that is used to treat people with highly drug-resistant forms of TB. It consists of the TB Alliance developed antibiotic pretomanid, along with two other antibiotics: bedaquiline and linezolid. While the BPaL regimen was approved by the drug regulator in India last year, TB Alliance’s latest trial results show that the high efficacy of the BPaL regimen can be maintained with lower dosing of linezolid, which is associated with challenging side effects including peripheral neuropathy. This is expected to boost the use of the drug. “TB Alliance is encouraged by these results, which support the use of reduced linezolid dosing in the sixmonth, three-drug, all-oral BPaL regimen,” Alliance president and chief executive Mel Spigelman says. While many patients stop treatment due to the length of the present treatment, old treatment regimens require more than 18 months of five or more drugs with low treatment success rates. India accounts for more than 1 in 4 of all cases of active TB diseases, including nearly 1.20 lakh cases of drug-resistant forms of TB. “Innovative approaches are urgently needed to turn the tide on TB and are essential to meeting national and global targets for TB elimination. Short, simple, safe and effective therapies must be a cornerstone of any TB control effort. By reducing the cost and treatment time required for highly drug-resistant forms of TB, TB programs can be freed up to devote scarce resources to treat forms of the disease and other serious challenges like Covid-19 control,” says Spigelman. A national TB control programme in India registered a 25% fall in the detection of new patients during first half of 2021 when compared with corresponding period in 2019. The WHO estimates that these Covid-19 related disruptions in access to TB care could cause an additional half a million deaths, losing progress of a decade.

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