WHO updates guidelines for treating drug-resistant tuberculosis

The World Health Organization (WHO) has released its updated consolidated guidelines on treatment for drug-resistant tuberculosis (DR-TB), which features major improvements in treatment options for people with multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB), including a regimen that offer better patient outcomes.

The 2022 updates include a new recommendation on the use of a novel all-oral six-month regimen made up of bedaquiline, pretomanid, linezolid and moxifloxacin (BPaLM) for patients with MDR/RR-TB or MDR/RR-TB with additional resistance to fluoroquinolones (pre-XDR-TB). The new regimen offers better outcomes and significantly shortens the duration of treatment, facilitating considerable improvement to the quality of life for people with MDR/RR-TB.

Who can utilise the World Health Organization’s 2022 update?

The document includes all current recommendations on treatment of DR-TB and is supplemented by an operational handbook designed to aid the implementation of WHO recommendations by Member States, technical partners and those involved in the management of patients with DR-TB. The updated recommendations provide practical guidance on how to apply the recommended treatment options at a national and global scale to enable positive impact.

The information is designed for national TB programmes, or their equivalents in Ministries of Health, policy makers and technical organisations working on TB and infectious diseases in public and private sectors and in the community.

WHO stated it 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.

Implementing the new drug-resistant tuberculosis treatment regimen

To support implementation of the new DR-TB treatment regimen, WHO state that it plans to set up a regular online discussion platform involving high MDR/RR-TB burden countries, civil society, technical partners and donor community.

‘’Building on the newly available data, we now have a better and shorter all-oral treatment option for drug-resistant tuberculosis. 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,” commented 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.’’