A study published in the Annales Africaines de Médecine has demonstrated that the BPaL treatment regimen, introduced in the Democratic Republic of Congo (DRC) in 2022, offers improved survival benefits for patients with pre-extensively drug-resistant tuberculosis (pre-XDR-TB). Conducted by researchers from the University of Kinshasa and Kinshasa University Hospital, the study aimed to evaluate the effectiveness of the BPaL regimen compared to an individualized bedaquiline-based regimen.
The study, a historical cohort analysis, included 58 patients with pre-XDR-TB who received either the BPaL regimen (27 patients) or a long-term bedaquiline-based regimen (31 patients). The BPaL regimen was administered between 2022 and 2024, while the traditional regimen was given between 2015 and 2017. Overall survival rates were significantly better in the BPaL group compared to the traditional regimen group (p = 0.001).
The study also found that HIV-positive patients had a worse prognosis (p 0.0001). In the general population, predictors of mortality included symptoms of multidrug-resistant tuberculosis (HR: 3.21; 95% CI: 1–10.2; p = 0.048) and positive HIV serology (HR: 5.9; 95% CI: 1.6–21.8; p = 0.007). These findings highlight the importance of considering patient characteristics when selecting treatment regimens.
The BPaL regimen, which was introduced in the DRC in 2022, has shown promise in improving treatment outcomes for patients with pre-XDR-TB. The regimen's effectiveness is attributed to its combination of bedaquiline, pretomanid, and linezolid. The study's results support the continued use of the BPaL regimen in the DRC and other settings where pre-XDR-TB is prevalent.
The study was conducted by a team of researchers from the University of Kinshasa and Kinshasa University Hospital, including Deogrâce Nkiomo Munzengi, Innocent Murhula Kashongwe, Marc Tshilanda, Luc Losenga Lukaso, Benoit Obel Kabengele, Fina Mawete, Leopoldine Mbulula, Pierre Umba, and Zacharie Munogolo Kashongwe. The researchers' work contributes to the growing body of evidence on the effectiveness of the BPaL regimen in treating pre-XDR-TB.
The study's findings have implications for tuberculosis (TB) control programs in the DRC and other countries where pre-XDR-TB is a significant public health concern. The BPaL regimen offers a promising treatment option for patients with pre-XDR-TB, and its implementation could help improve treatment outcomes and reduce mortality rates.
The study was published in the Annales Africaines de Médecine, a peer-reviewed journal that focuses on medical research in Africa. The article is available online and can be accessed through the journal's website.
Key points
- The BPaL regimen shows improved survival in pre-XDR-TB patients compared to a traditional bedaquiline-based regimen.
- HIV-positive patients had a worse prognosis in the study.
- Predictors of mortality included symptoms of multidrug-resistant tuberculosis and positive HIV serology.
