New TB treatment is shorter, safer and more effective for drug-resistant TB

TB PATIENTS' will now receive a much shorter treatment regimen that is safer and more effective than the current treatment care, following the World Health Organization's (WHO) announcement to update global guidance on treatment.

Last year, TB-Practecal, a clinical trial led by Doctors Without Borders found that a new all-oral six-month treatment regimen is safer and more effective at treating rifampicin-resistant tuberculosis (RR-TB) than the current accepted standard of care.

These results signal the start of a new chapter for people with drug-resistant tuberculosis (DR-TB) who currently face lengthy treatment regimens of up to 20 months that can include painful injections and up to 20 pills a day that can cause severe sideeffects on people's physical, mental and financial well-being.

The WHO is now recommending programmatic use of the six-month BPaLM regimen – comprising bedaquiline, pretomanid, linezolid (600 mg) and moxifloxacin in MDR-TB patients in place of longer, existing regimens.

The WHO is also recommending another shorter treatment: the BPaL combination, in patients with increased drug-resistance as both regimens showed high treatment success.

The trial enrolled 552 patients overall in seven sites across Belarus, South Africa and Uzbekistan.

The phase II/III clinical trial found that the new shorter BPaLM treatment regimen was very effective against rifampicin-resistant TB.

Eighty-nine percent of patients in the BPaLM group were cured, compared with 52% in the standard of care group.

“The shorter treatment would mean a lot, as I think when you are on treatment some parts of your life feel like they are put on hold. Before the trial gave me hope, I couldn't even see the slightest glimpse of recovering from multidrug-resistant tuberculosis,” said Awande Ndlovu, who was enrolled in the trial at the Think Hillcrest Clinical Trial Unit in South Africa.

Launched in 2017, TB-Practecal is the first-ever multi-country, randomised, controlled clinical trial to report on the efficacy and safety of a six-month, all-oral regimen for MDR-TB.

While this new regimen provides fresh hope for the 500 000 people who fall sick each year with MDR-TB, the current lowest global price for a six-month treatment course of BPaLM is $800 (R12 660).