BPaL’s 6-month regimen for drug-resistant TB to be launched nationwide in January after training sessions conclude. (Wikimedia Commons)  
Medicine

National TB Elimination Programme Prepares for Launch of Shortest Drug-Resistant TB Treatment BPaL

Six-month regimen expected to improve treatment outcomes; training sessions underway for doctors across Indian states

Ankur Deka

Mumbai: The National Tuberculosis (TB) Elimination Programme (NTEP) has initiated training sessions for doctors across the country to prepare for the rollout of BPaL, the shortest treatment regimen for drug-resistant TB to date. BPaL, a combination of bedaquiline, pretomanid, and linezolid, offers a six-month treatment period compared to the existing average of 18 months. The new regimen is expected to be introduced nationwide in January, following the completion of training programs by the end of the year.

Dr. Vikas Oswal, a Chembur-based pulmonologist and member of the NTEP’s technical expert team, reported that the first three-day national training module on the updated TB treatment guidelines and BPaL was recently completed for doctors in Delhi. Training for Maharashtra’s public health doctors is scheduled for November in Pune. Before the regimen’s formal rollout, all states must complete train-the-trainer programs, ensuring smooth implementation across public healthcare systems.

Training programs underway for doctors as India prepares to implement the shortest-ever treatment for drug-resistant TB. (Representational Image-Wikimedia Commons)

BPaL has already been introduced in over 40 countries, and the combination was approved in India earlier this year following positive trial results. A three-year clinical study involving 403 Indian patients with drug-resistant TB demonstrated a 90% cure rate. Of the 403 participants, 352 patients were successfully cured, though one patient with chronic obstructive pulmonary disease (COPD) succumbed during the trial. Additionally, 11 patients experienced a relapse, and 19 others reported severe adverse reactions during the 12-month follow-up period.

One of the significant findings from the trial was the confirmation that a daily dose of 600 mg of linezolid is just as effective as the previously recommended 1,200 mg dose. Dr. Oswal stated that doses as low as 300 mg to 600 mg can achieve similar outcomes, reducing the risk of adverse reactions in patients.

The BPaL regimen offers several benefits over traditional TB treatments. Patients need to take only three tablets daily and no injections are required, simplifying adherence to the therapy. Public health experts anticipate that the shorter treatment period and fewer medications will result in fewer dropouts, addressing a key challenge in managing multidrug-resistant TB (MDR-TB).

The streamlined regimen has been eagerly awaited by health authorities, with hopes that it will lead to improved treatment outcomes and patient compliance. As India continues its battle against drug-resistant TB, the BPaL regimen is expected to play a pivotal role in achieving national elimination targets. The NTEP is actively monitoring progress to ensure the treatment is accessible to all patients through public health channels.

(Input from various sources)

(Rehash/Ankur Deka/MSM)

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