- The preliminary findings of a randomised phase-3/4 study done in India to assess the safety and efficacy of BPaL Regimen, an all-oral, short-course therapy, are encouraging.
- Individuals with pre-XDR TB or treatment-intolerant/non-responsive MDR pulmonary TB are given BPaL.
What exactly is BPaL?
- Bedaquiline, Pretomanid, and Linezolid (BPaL) are the sole medications used in the trial.
- The treatment is only 26 weeks long, as opposed to the traditional 18-month treatment using eight to nine tablets every day.
Trial Results
- It provided a much lower amount of pills per day, leading in enhanced treatment adherence and outcomes.
- Approximately 70% of trial participants finished the 26-week treatment, with a cure rate of more than 85%.
- In comparison, even with perfect adherence, the cure rate for traditional DR-TB treatment is 60-65%.
Superiority in Treatment
- Cases of Advanced Tuberculosis: Despite the fact that the study participants had advanced TB affecting both lungs, the cure rate was greater than 85%, confirming the superiority of the BPaL short-course therapy.
- The Value of Early Diagnosis: For individuals with pre-XDR TB, early diagnosis and treatment with the three-drug regimen can result in even better outcomes.
Problems with the treatment
- Three to four study participants reported severe side effects, but these were either treated or happened too late in the disease’s course to be helpful.
- Mild side effects of linezolid included a decrease in haemoglobin and platelet counts, as well as neuropathy (tingling and numbness in the legs).
The Tuberculosis Epidemic in India
- Total TB Cases: In 2021, around 21.3 lakh (2.13 million) TB cases were reported in India.
- Incidence Rate: In 2021, the incidence rate of tuberculosis in India was 210 cases per lakh population.
- Drug-Resistant Tuberculosis: The number of drug-resistant tuberculosis patients in India has decreased from around 1.49 lakh in 2015 to 1.19 lakh in 2021.
- Initiatives of the Government: To battle tuberculosis, India has set the goal of eliminating the illness by 2025, and numerous programmes, such as active case detection, screening, and increased access to diagnostic tests and treatment, have been adopted.
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