Mumbai: The National Tuberculosis (TB) Elimination Programme has started training sessions for doctors to introduce BPaL, the shortest treatment for drug-resistant TB to date. BPaL, a combination of bedaquiline, pretomanid and linezolid, can treat drug-resistant forms of TB in just six months compared with the present average of 18 months.
The treatment is expected to be launched in early Jan, following the completion of trainer-doctor training in all states over the next two months.
Dr Vikas Oswal, a Chembur-based pulmonologist and member of the NTEP technical expert team, said, “On Wednesday, we completed the first national three-day training module on the new TB treatment guidelines and BPaL for Delhi’s doctors.” The training for Maharashtra’s public health doctors is scheduled to take place in Pune during the second half of Nov. The training-of-trainers programme must be completed in all states before the BPaL treatment can be implemented.
BPaL has been eagerly anticipated and has already been introduced in more than 40 countries. Indian authorities approved the combination a few months ago, following the results of a three-year trial that demonstrated a 90% cure rate. The Indian trial involved 403 patients with drug-resistant TB, of whom 352 were cured while one patient with COPD passed away. Eleven patients experienced a recurrence, and 19 others had severe adverse reactions during the 12-month followup.
The trial also confirmed that a daily dosage of 600mg of the antibiotic linezolid is as effective as the originally prescribed 1,200mg. “The Indian study proved that 600mg to 300mg of linezolid is also as effective as 1,200mg,” said Dr Oswal. The most significant advantage of BPaL for patients, compared to older regimens, is that only three tablets need to be taken daily, and there are no daily injections. Public health experts expect the shorter and fewer-drug regimen will lead to a decrease in the drop-out rate associated with MDR-TB.
