New regimens cut multidrug-resistant TB treatment time

TB sufferers and support staff meet
Copyright: Panos

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  • Two new drugs could boost treatment of patients with MDR-TB
  • Regimens involving the drugs cut treatment from two years to six months
  • An expert says the drugs could reduce workload of doctors managing TB patients

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[KAMPALA] Two new drug regimens have shown promise to enhance treatments of patients suffering from drug-resistant tuberculosis (TB).
Latest figures from the WHO show that of those who are able to access treatment, only half of those with multi-drug resistant (MDR) TB and only 28 per cent of those with extensively drug-resistant (XDR) TB are cured.
According to Mel Spigelman  the president and CEO of Global Alliance for TB Drug Development (TB Alliance), the two new regimens — BPal and BPaMZ — promise to be simpler and affordable in part due to the shorter treatment duration especially for patients with MDR-TB or XDR-TB.

“These are promising treatments for all forms of TB.”

Alphonse Okware, Mulago Hospital, Uganda


The regimens involve novel drugs, Janssen’s bedaquiline (B) and TB Alliance’s candidate drug pretomanid (Pa) in combination with few TB drugs.
Preliminary results of trials involving the regimens were presented at the CROI (Conference on Retroviruses and Opportunistic Infections in the United States last month (15 February).
Treating MDR-TB can take from nine months to more than two years and is expensive while treating XDR-TB has no standard of care and patients are often treated for years.
Now treatment for patients with drug-resistant patients may be reduced to about four to six months while the same regimen could treat most drug-resistant TB in about six months from two years, Spigelman adds.
Two trials are being conducted in Sub-Saharan Africa. BPaL regimen is made up of bedaquiline (B), pretomanid (Pa) and linezolid (L) and is being used in Nix-TB trial whereas the NC-005 trial has BPaMZ regimen comprising bedaquiline, pretomanid, moxifloxacin (M) and pyrazinamide (Z).
The Nix-TB, a phase III trial began in March 2015 and is continuing in South Africa. It enrolled patients with no other treatment options available because all other TB drugs had failed.
According to the TB Alliance, the trial showed that most patients with XDR-TB or treatment-intolerant MDR-TB who completed six months of oral BPaL treatment tested negative for TB in their sputum.
The NC-005 trial began in October 2014 and completed patient follow-up in February 2016 at seven sites in South Africa, two in Tanzania, and one in Uganda, and enrolled 240 patients for eight weeks.
Preliminary findings show that BPaMZ is effective in treating almost all drug-resistant TB and most MDR-TB.

“These are promising treatments for all forms of TB,” says Alphonse Okware, the head of the National TB Referral Treatment Centre at Mulago Hospital, Uganda.
Okware says the new drugs will benefit patients by eliminating admissions to hospitals to receive daily injections, thus saving resources. And it will improve cure rates and reduce the number of TB cases, thereby result in low caseload for doctors.
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.