WHO has just released updated consolidated guidelines on the treatment of drug-resistant TB (DR-TB) featuring major improvements in treatment options for people with multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB). The guidelines include a new recommendation on the use of a novel all-oral 6-month regimen composed of bedaquiline, pretomanid, linezolid and moxifloxacin (BPaLM) in people suffering from MDR/RR-TB or MDR/RR-TB with additional resistance to fluoroquinolones (pre-XDR-TB). The newly recommended BPaLM regimen offers better outcomes, remarkably shortens the duration of treatment, and thus significantly improves quality of life for people with MDR/RR-TB.
”Building on the newly available data, we now have a better and shorter all-oral treatment option for drug-resistant TB. This is a historic change that will be of great benefit to people suffering from drug-resistant TB, easing the burden on health systems and saving lives,” said Dr. Tereza Kasaeva, Director of WHO’s Global TB Programme. “We now call for urgent action by national TB programmes and partners in rapidly transitioning to the new drug-resistant TB treatment regimen.”
The WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment – Drug-Resistant Tuberculosis Treatment, 2022 update includes all the current recommendations on treatment of DR-TB, and is complemented by an operational handbook designed to assist the implementation of WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR-TB. The WHO Operational Handbook on Tuberculosis, Module 4: Treatment – Drug-Resistant Tuberculosis Treatment, 2022 update provides practical guidance on how to put in place the recommended treatment options at the scale needed to achieve national and global impact.
The updated guidelines and supporting operational handbook are designed for use by national TB programmes, or their equivalents in Ministries of Health, policy makers and technical organizations working on TB and infectious diseases in public and private sectors and in the community. These documents aim to facilitate uptake of WHO policy in the field and thus improve the overall quality of TB services.
WHO welcomes new initiatives by the public and private sectors to reduce the pricing of pretomanid and potentially other component medicines – that will lower the cost of the new BPaLM/BPaL treatment regimen and make it more accessible.
To facilitate and promote implementation of the new regimen for the treatment of DR-TB WHO will set up a regular online discussion platform that will include high MDR/RR-TB burden countries, civil society, technical partners and donor community.