Six-Month BPaLM Regimen Shows 92% Treatment Success Rate in Real-World Study in India

A new prospective cohort study from Bahraich District in Uttar Pradesh adds powerful evidence to the growing global data on the effectiveness of the six-month BPaLM regimen, a shorter, all-oral treatment for most forms of drug-resistant TB. Published in the Journal of Population Therapeutics & Clinical Pharmacology, the study reaffirms what communities, clinicians, and the World Health Organization (WHO) have been advocating: shorter regimens work, and they save lives. 

This recent study was conducted in India, a country which accounts for approximately a third of the world’s DR-TB burden. India is currently in the process of scaling up access to the BPaLM treatment regimen and real-world programmatic data from district-level settings is starting to highlight the impact of this transition.  

The top line finding of the study shows that, of a 50-person cohort, 92% of people treated for DR-TB with BPaL (under direct observation) were free of DR-TB infection at 24 weeks (just under 6 months) of treatment, with no mortality observed. This success rate mirrors and, in some cases, exceeds outcomes from major global trials such as TB PRACTECAL and ZeNix. 

Further, adverse drug reactions remained manageable, and the regimen did not have to be discontinued for any of the patients in the cohort. The most common side effects were mild peripheral neuropathy, anemia, and GI intolerance.  

Taken as a whole, the finding support the regimen as safe and effective under routine programmatic conditions, which is a crucial finding as India expands BPaLM access nationwide. 

As nations move to adopt and scale BPaL/BPaLM, this study adds compelling support for urgent, widespread implementation. It demonstrates that real-world conditions, even in resource-limited district hospitals, are not a barrier to excellent outcomes.  

This is great news to communities, as the scale up of six-month DR-TB regimens like BPaLM can lead to improved treatment outcomes, fewer side effects, less time away from work or school, and reduced financial strain associated with treatment.