Seeking shorter, more effective, and economically viable treatment option for drug-resistant tuberculosis (DR-TB), a group of doctors and patients have sought urgent government intervention to roll out the BPaL regimen, comprising only three drugs – Bedaquiline, Pretomanid, and Linezolid.
(For top health news of the day, subscribe to our newsletter Health Matters)
The regimen, with a treatment duration of just 26 weeks, stands in stark contrast to the existing conventional treatment for DR-TB, which can require patients to take over 4,000 to 5,000 tablets over 18 to 21 months.
Dr Amitesh Gupta, assistant professor, Pulmonary Medicine, Maulana Azad Medical College and Hospital, said, “Current Drug Resistance TB treatment depends on multiple factors. There are approx 12-15 drugs out of which 5 to 6 drugs are given to the patients, case to case basis.
The newer BPaL regimen uses only three drugs — bedaquiline, pretomanid and linezolid — and the treatment lasts only for 26 weeks, in contrast to eight-nine tablets each day for 18 months in the conventional treatment for DR-TB.
The group said that the BPaL regimen, which has received recommendations from the U.S. Food and Drug Administration (FDA) in 2019 and the World Health Organization (WHO) in 2022, has already been rolled out in over 70 countries, including South Africa, Ukraine, Indonesia, Pakistan, Afghanistan, Philippines, and Vietnam.
Highlighting the key advantages of the BPaL regimen, Dr. Vikas Oswal, TB specialist and national technical expert on TB, stated that the BPaL regimen offers not only a significantly shorter treatment duration but also a drastic reduction in the number of tablets patients need to take. This has a direct impact on treatment adherence, leading to improved outcomes.
“Cure rates after completing 26 weeks of treatment are expected to exceed 89%, compared to the 60-65% cure rate seen with strict adherence to the conventional DR-TB Treatment, yet too early to comment on relapse rate, any regimen proves out to be successful if the relapse rate too is low,” he said.
Blessina Kumar, Global Coalition of TB Advocates added that Indian TB patients have been suffering for far too long due to the gruelling and lengthy treatment regimens. The BPaL regime promises a chance for a better quality of life. “We urge the Indian government to prioritize the rollout of this regimen to help us achieve the End TB goals by 2025,” she added.
Emphasising the urgency of introducing the BPaL regimen in India, Dr. Ravikant Singh, founder, Doctors For You, noted that BPaL regimen has shown remarkable success in numerous countries, offering a ray of hope for drug-resistant TB patients.
“Apart from being highly efficacious and cost-effective, it is also a very simple regimen to understand and roll out by healthcare workers. This regimen significantly reduces the logistics cost to treat TB cases which leads to overall reduction in treatment cost for DR TB patients. We are hopeful that the Indian government will soon launch this regimen to achieve the UN target of Ending TB by 2030,” he added.
The release issued by the group added that studies estimate an annual global savings of $740 million due to the adoption of this regimen. Given that India accounts for a third of the global MDR/RR-TB treated patients, this could translate to savings of nearly $250 million per year for our country. “Beyond the economic benefits, we cannot ignore the improved quality of life it promises to TB patients,” said the group.
