Results of a ZeNix phase III clinical trial has found that the BPal treatment regimen remains effective against highly drug-resistant strains of tuberculosis (TB) with a reduced dosage.
- Developed by a non-profit organization, TB Alliance, Pretomanid is the newest anti-TB drug, prescribed as part of the BPaL regimen, which includes two other drugs – Bedaquiline and Linezolid.
Salient features of BPal
- The results from the trial, which was led by the TB alliance were published in the New England Journal of Medicine on September 1.
- ZeNix is a clinical trial testing the BPal regimen, which consists of Pretomanid, Bedaquiline and Linezolid.
- The trails have shown that BPal treatment remains effective against highly drug-resistant TB strains.
- The present TB treatment has 13-14 drugs daily given for a period of 18-24 months. The BPAL regimen has a maximum of three to four drugs daily where it can be given only for six months.
What is Drug-resistant TB?
Drug-resistant TB develops when the long, complex, decades-old TB drug regimen is improperly administered, or when people contract TB from others who have drug-resistant disease.
- Mono-resistance: resistance to one first-line anti-TB drug only
- Poly-resistance: resistance to more than one first-line anti-TB drug, other than both isoniazid and rifampicin
- Multidrug resistance (MDR): resistance to at least both isoniazid and rifampicin
- Extensive drug resistance (XDR): resistance to any fluoroquinolone, and at least one of three second-line injectable drugs (capreomycin, kanamycin and amikacin), in addition to multidrug resistance
- Rifampicin resistance (RR): resistance to rifampicin detected using phenotypic or genotypic methods, with or without resistance to other anti-TB drugs. It includes any resistance to rifampicin, in the form of mono-resistance, poly-resistance, MDR or XDR.
Global TB Report 2021
- The Global TB Report 2021 stated that the mortality rate due to all forms of TB between 2019 and 2020 increased by 11 per cent in India.
- In absolute numbers, the total number of estimated deaths from all forms of TB, excluding HIV, for 2020 was 4.93 lakh (4.53-5.36 lakhs) in the country.
What is a Tuberculosis?
- Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis. bacteria that are spread from person to person through the air.
- TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine.
What is a TB Alliance?
- TB Alliance is a not-for-profit organization dedicated to the discovery, development and delivery of better, faster-acting and affordable tuberculosis drugs that are available to those who need them.
- TB Alliance was conceived at a February 2000 meeting in Cape Town, South Africa, where 120 representatives from academia, industry, major agencies, non-governmental organizations, and donors gathered to discuss the need for new TB treatments.
- The alliance was created by the “Declaration of Cape Town” which provided a road map for TB drug development.
- In 2019, TB Alliance became the first not-for-profit organization to develop and register an anti-TB drug.
