INDIA – India is stepping up its fight against multi-drug resistant tuberculosis (MDR-TB) with the National Tuberculosis Elimination Programme (NTEP) launching a nationwide training initiative to equip doctors with skills to administer BPaL.
BPaL is a promising new regimen that shortens drug-resistant TB treatment from 18 months to just six.
BPaL, combining bedaquiline, pretomanid, and linezolid, simplifies treatment to three daily tablets, which should reduce drop-out rates and improve outcomes by making adherence easier for patients.
The NTEP’s training sessions began with a three-day workshop in Delhi to familiarize doctors with the latest TB treatment guidelines and protocols for BPaL.
Dr. Vikas Oswal, a pulmonologist from Chembur and member of NTEP’s technical expert team, noted the significance of this step.
“On Wednesday, we completed the first national three-day training module on the new TB treatment guidelines and BPaL for Delhi’s doctors,” he shared.
Training in Maharashtra is scheduled for mid-November in Pune, with plans to expand to all states by January 2024.
The comprehensive training will enable a timely rollout of BPaL, setting the stage for nationwide accessibility and helping India achieve ambitious TB elimination goals.
“With BPaL, patients can complete their treatment in half the time, with fewer drugs and significantly fewer side effects,” noted Dr Vikas Oswal.
MDR-TB remains a significant global health challenge, with 450,000 new cases of rifampicin-resistant TB reported in 2021, and a high mortality rate, as 15% of MDR/RR-TB patients do not survive.
In response, the World Health Organization (WHO) updated its guidelines in December 2022, recommending BPaL as a preferred six-month regimen for MDR/RR-TB cases without fluoroquinolone resistance, a shift expected to streamline treatment globally and improve patient outcomes.
Proven efficacy and reduced side effects
BPaL has already shown remarkable results globally and is currently used in over 40 countries. In India, it received regulatory approval after a three-year clinical trial that saw a 90% cure rate among 403 patients with MDR-TB.
Among these patients, 352 achieved complete recovery. The trial also highlighted the efficacy of reduced dosages, confirming that a daily 600mg dose of linezolid is as effective as the previously prescribed 1,200mg dose, and may further improve treatment adherence.
“The Indian study proved that reducing linezolid from 1,200mg to 600mg or even 300mg daily is effective, which offers fewer side effects while maintaining efficacy,” Dr. Oswal explained.
This advancement, along with BPaL’s all-oral formulation, eliminates the need for daily injections and minimizes adverse reactions, a major benefit for patient compliance.
