The Ukrainian doctor Volodimir will always remember the day he took the last dose of a treatment against tuberculosis shorter, more effective and with fewer side effects, which is a turning point in the fight against this deadly disease and it changed his life.
Before, Volodimir, 25 years old, a resident of kyiv who preferred not to give his last name, followed another treatment almost twice less effective, which involved taking more tablets and which had caused neurological side effects.
These disappeared when he switched to the new treatment, which has lasted only six months against the two years of the previous one.
“It was so easy”Volodimir told AFP, who preferred not to give his last name.
On the day of the last dose, a scan showed that there are no traces of tuberculosis.
Next week he wants to go back to work after eight months off. “Now, I can start living again”Rejoices.
Tuberculosis was the main infectious cause of death before the arrival of COVID-19, with 1.5 million victims per year.
About 5% of new cases showed resistance to prescribed antibiotics, making treatment difficult.
But a new drug regimen, called BPaL because it combines the antibiotics bedaquiline, pretomanid and linezolid, has come a long way since its approval by the US Food and Drug Administration in 2019.
Reduced dose
Research in 2020 showed that BPaL treatment cured more than 90% of patients, but that there was a high rate of side effects linked to linezolid, especially nerve pain or spinal depression, a drop in the production of cells responsible for immunity.
But a study published Wednesday in the New England Journal of Medicine showed that the dose of linezolid can be cut in half without significantly lowering the effectiveness of the treatment.
The researchers conducted a trial with 181 patients with resistant tuberculosis in Russia, South Africa, Georgia and Moldova, the countries with the highest rates of this disease.
The conclusion is that if 1,200 milligrams of linezolid for six months is 93% effective, it is maintained at 91% with a dose of 600 milligrams.
In this trial, the number of participants suffering from peripheral neuropathy (causing nerve pain) increased from 38% to 24% and those with bone marrow suppression from 22% to 2%.
“It is the beginning of the end of drug-resistant tuberculosis”tells AFP the lead author of the study, Francesca Conradie, from the University of the Witwatersrand in South Africa.
“The faster you treat someone’s TB, the less contagious they are. It’s like covid in many ways.”He says.
“Big steps”
In addition, the treatment is easier for patients: they go from having to take up to 23 pills a day and 14,000 in two years to only five pills a day and less than 750 in the six months of duration.
For Natalia Lytvynenko, who supervised BPaL treatment in Ukraine, this more manageable number of pills makes it easier to follow treatment for patients displaced by war.
The World Health Organization said this year that it will update its guidelines to recommend BPaL with 600 milligrams of linezolid for most patients with resistant tuberculosis.
Is about “Big steps”said two experts in the field not involved in Wednesday’s study.
The BPaL treatment “It is one of the decisive advances in scientific research on tuberculosis in this century”Guy Thwaites of the University of Oxford and Nguyen Viet Nhung of the Vietnam National Tuberculosis Control Program wrote in an editorial in the New England Journal of Medicine.
These advances come amid fears that the COVID-19 pandemic will slow down research in the fight against tuberculosis.
Source: Gestion
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