Short-Term Regimen for TB

Table of Contents

Context

The Union Health Ministry has recently approved the introduction of a new treatment regimen for multidrug-resistant tuberculosis (BPaL Regimen) in India.

MDR-TB: A Growing Concern

MDR-TB occurs when TB germs become resistant to rifampicin and isoniazid, two major TB drugs.
Mortality Risk: Carries a 30-40% risk of death.
Global Burden (2023):
- 1,75,923 cases reported to WHO.
- India’s share: 27% of global MDR-TB cases.
Causes: Lack of adherence to TB treatment & Misuse of TB drugs through improper regimens.

Issues with Existing TB Treatments

Drug-Sensitive (DS) TB: Treatment duration is 6 months, involving 4 drugs initially.
Drug-Resistant (DR) TB:
- Longer treatment: 18 months or more.
- Higher pill burden: At least five drugs.
  - Severe side effects (hearing loss, depression and menstrual disruptions).

Shorter Regimens: The BPaL Regimen

Components: Bedaquiline, Pretomanid Linezolid (BPaL), Duration – 6 months.

● Advantages:

Reduced treatment duration.
Improved adherence due to lower pill burden.
Decreased economic burden on patients.

Tuberculosis (TB)

● It is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person.

○ TB is caused by a bacterium called Mycobacterium tuberculosis, belonging to the Mycobacteriaceae family.

● Transmission: TB spreads from person to person through the air.

● Types:

○ Pulmonary TB: Affects the lungs

○ Extra-Pulmonary TB: Affects other organs.

● TB is a treatable and curable disease.

● Treatment:

○ Vaccine: Currently, Bacille Calmette-Guérin (BCG) is the only licensed vaccine available for the prevention of TB.

○ Major drugs (4): Isoniazid (INH), Rifampicin, Pyrazinamide & Ethambutol.

● TB Elimination Targets:

○ India – National TB Elimination Programme (NTEP) to eliminate TB by 2025.

○ Globally – End TB Strategy of WHO to eliminate TB by 2030.

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