Good news for TB patients: shorter, all-oral treatments for drug-resistant strains (DR-TB) still offer hope for improved outcomes and access.
Results presented at the Union World Conference on Lung Health in Paris show that the World Health Organization (WHO)-recommended 6-month, all-oral BPaL (bedaquiline, pretomanid, and linezolid) regimen had a nearly 95% cure rate in countries with a high burden of DR-TB. Furthermore, four alternative shorter regimens proved more effective than the previously standard 18- to 24-month regimens. Additionally, studies from South Africa and Vietnam suggested that a daily oral antibiotic could reduce the risk of developing DR-TB in both adults and children.
Operational research results from the LIFT-TB (Leveraging Innovation for Faster Treatment of Tuberculosis) Trial, presented at the conference, revealed that 94.5% of participants were confirmed TB-free 6 months after completing BPaL treatment. This shorter regimen, officially recommended by the WHO for all patients with multidrug-resistant (MDR) or rifampicin-resistant (RR) TB in 2022, showed cure rates of 90% or higher and far fewer side effects, making treatments much more patient-friendly.
Meanwhile, the results from the endTB trial, which evaluated five 9-month treatment regimens in a population that included historically excluded patients, suggested that other shortened regimens may prove nearly as effective, achieving favorable outcomes in 85-90.4% of participants with MDR/RR-TB.
In addition, a Unitaid-funded trial in South Africa found that administering levofloxacin for 6 months reduced the risk of developing MDR-TB in children under the age of 5 by 56%. The TB-CHAMP trial, which tested the intervention in children exposed to adults with MDR-TB in their household, found very few side effects.
As researchers and global health authorities continue to gather data, the hope is to expand adoption of these effective and patient-friendly treatments to all who need them. The ultimate goal is to ensure that all people with drug-resistant tuberculosis have access to better and more manageable treatment options.