Latest advancements in TB science in spotlight

Bobby Ramakant – CNS
Contd from previous issue
Treatment of MDR-TB : Until recently, the standard of care MDR-TB treatment regimen was 18-24 months long and gave a cure of around 50% with highly toxic drugs and painful daily injections given for a minimum of the first 6-months of treatment.
TB PRACTECAL study led by MSF is evaluating a 6 months all oral regimens containing Bedaquiline and Pretomanid in combination with Linezolid, Moxifloxacin and Clofazimine. The study design has 4 groups: one group gets the WHO standard of care regimen; second group gets a regimen of Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin; third group gets a regimen of Bedaquiline, Pretomanid, Linezolid, and Clofazimine; and fourth group gets a regimen of Bedaquiline, Pretomanid, and Linezolid. As of now, a regimen of Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin, with a tapered dose of Linezolid, has been found to be non-inferior (safe and efficacious) to the standard of care (9-24 months) treatment of rifampicin-resistant TB of the lungs. Outcomes of other regimens are expected to be reported soon. (To be contd)