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Last Updated : Aug 05, 2020 10:07 PM IST | Source: Moneycontrol.com

Health activists hail WHO's inclusion of bedaquiline, delamanid for treating DR-TB

The drugs bedaquiline and delamanid were the first new TB treatments to become available in half a century.

The World Health Organisation (WHO's) recent revision of its tuberculosis guidelines, allowing inclusion of both bedaquiline and delamnind for treatment of patients suffering from drug-resistant tuberculosis (DR-TB), has been welcomed by healthcare activist groups.

The drugs bedaquiline and delamanid were the first new TB treatments to become available in half a century.

The June release of the WHO’s ‘Consolidated guidelines on tuberculosis- treatment of DRTB’ finally provided for the concurrent use of bedaquiline and delamanid among patients who have limited treatment options.


Bedaquiline is sold by US drug maker Johnson & Johnson and delamanid by Otsuka

The WHO update will now help fast-track inclusion of these approaches in the national guidelines. The inclusion of the oral drugs such as bedaquiline and delamanid shortens the treatment regimen and helps reduce the pill burden on DR-TB patients.

Medecins Sans Frontieres/Doctors Without Borders (MSF) has welcomed the revision made by WHO to its tuberculosis (TB) guidelines, allowing for safe use of a treatment regimen including both bedaquiline and delamanid for patients suffering from drug-resistant tuberculosis (DR-TB), while urging a faster uptake in India for patients with extensively drug-resistant TB (XDR-TB).

Data from MSF’s DR-TB project in Mumbai contributed to generate the evidence. The new regimen has shown treatment success rates of up to 70 percent for the severest of DR-TB cases.

In India the National Institute of Tuberculosis and Respiratory Disease (NITRD) published a study on bedaquiline and delamanid given together in a salvage regimen and found it is efficacious with a low rate of adverse events and recommended that the new drugs should be provided as a life-saving option to DR-TB patients with limited treatment options.

“It’s critical that the national TB programme now make both the new TB drugs available concurrently to patients who need them to help accelerate access to life saving treatment for DR-TB patients. This is also in line with WHO’s push to countries to scale-up use of injectable-free regimens so that DR-TB patients can be treated in the safety of their homes during the COVID-19 epidemic,” says Leena Menghaney, South Asia Head of MSF Access Campaign.

While shortening its duration, MSF is also focusing on improving existing treatment regimens for infants and children with DR-TB.

However, the registration for paediatric use of bedaquiline and delamanid for children aged 3 to 6 years old by J&J and Otsuka, respectively, is still pending.

This limits the options for children with DR-TB, who are at the greatest risk of life-long disability due to hearing loss from the continued use of injectables. Otsuka and J&J need to expand the registration of new drugs in India for paediatric use, so that they can be scaled-up for adolescents and younger children who need it.

MSF has advocated for several years with the National TB Elimination Programme (NTEP) in India to allow access to newer treatment regimens for its patients.

In 2019, it received support to procure bedaquiline, delamanid as well as Imipenem in bulk from the Global Drug Facility for 324 DR-TB patients in Mumbai with extensive drug resistance, who cannot be treated by usual treatment regimens.

As a result, the cost of a combined regimen known as combo has come down for the organisation to less than 10,175 euro (Rs 9 lakh) from more than 19,220 euro (Rs 17 lakh) per patient.

With an estimated 130,000 DR-TB cases each year, India has the highest burden in the world. In Mumbai, MSF has been providing not just medical treatment but holistic care to people living with DR-TB.
First Published on Aug 5, 2020 10:02 pm