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Availability of drugs and resistance testing for BPaLM regimen for rifampicin-resistant tuberculosis in Europe

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Title: Availability of drugs and resistance testing for BPaLM regimen for rifampicin-resistant tuberculosis in Europe
Authors: Günther, Gunar, Guglielmetti, Lorenzo, Kherabi, Yousra, Duarte, Raquel, Lange, Christoph, Adamides, Tonia, Akkerman, Onno, Andersen, Aase Bengaard, Bakos, Ágnes, Bjarnason, Agnar, Bruchfeld, Judith, Chesov, Dumitru, Codecasa, Luigi Ruffo, Cirillo, Daniela, Danilovits, Manfred, Davidavičienė, Edita, De Souza Galvão, Maria Luiza, Garnier, Sandrine, Gjocaj, Majlinda, Ibraim, Elmira, Kappnik, Michael, Khachatryan, Naira, Klimuk, Dzmitry, Kuksa, Liga, Jachym, Mathilde Frechet, Josefsdottir, Kamilla, Kaluzhenina, Anna, Mack, Ulrich, Makek, Mateja Jankovic, Manika, Katerina, Mclaughlin, Anne-Marie, Mema, Donika, Mengshoel, Anne Torunn, Muylle, Inge, Nanovic, Zorica, Özkara, Şeref, Perl, Sivan, Pesut, Dragica, Pierdou, Despo, Ryskulov, Galym, Skowroński, Marcin, Solovic, Ivan, Sukholytka, Mariia, Svetina, Petra, Terleeva, Yana, Tiberi, Simon, Togonidze, Tamara, Zhdanova, Elena
Source: Clinical Microbiology and Infection. 30(9)
Publisher Information: ELSEVIER SCI LTD, 2024.
Publication Year: 2024
Description: OBJECTIVES: Multidrug-resistant/Rifampicin-resistant tuberculosis (TB) is a major obstacle to successful TB control. The recommendation by the World Health Organization to use bedaquiline, pretomanid, linezolid and moxifloxacin (BPaL(M)) for 6 months, based on results of three trials with high efficacy and low toxicity, has revolutionized treatment options.METHODS: In this study, representatives of the Tuberculosis Network European Trialsgroup (TBnet) in 44/54 countries of the WHO Europe region document the availability of the medicines and drug susceptibility testing (DST) of the BPaL(M) regimen through a structured questionnaire between September to November 2023.RESULTS: 24/44 (54.5%), 42/44 (95.5%), 43/44 (97.7%), and 43/44 (97.7%) had access to pretomanid, bedaquiline, linezolid, and moxifloxacin, respectively. Overall, 23/44 (52.3%) had access to all the drugs composing the BPaL(M) regimen. 7/44 (15.9%), 28/44 (63.6%), 34/44 (77.3%) and 36/44 (81.8%) had access to DST for pretomanid, bedaquiline, linezolid and moxifloxacin, respectively. DST was available for all medicines composing the BPaL(M) regimen in 6/44 (13.6%) countries.CONCLUSION: Only in about half of the countries participating in the survey clinicians have access to all the BPaL(M) regimen drugs. In less than a fifth of countries, a complete DST is possible. Rapid scale up of DST capacity to prevent unnoticed spread of drug resistance and equal access to new regimens are urgently needed in Europe.
Document Type: Article
Language: English
ISSN: 1198-743X
DOI: 10.1016/j.cmi.2024.03.009
Access URL: https://research.rug.nl/en/publications/a256272d-9555-4a23-b7c4-cd0c9b679cd2
https://hdl.handle.net/11370/a256272d-9555-4a23-b7c4-cd0c9b679cd2
Rights: taverne
Accession Number: edsair.dris...01423..e126e9a551dbfdec4f5350e7605f0da4
Database: OpenAIRE
Description
Abstract:OBJECTIVES: Multidrug-resistant/Rifampicin-resistant tuberculosis (TB) is a major obstacle to successful TB control. The recommendation by the World Health Organization to use bedaquiline, pretomanid, linezolid and moxifloxacin (BPaL(M)) for 6 months, based on results of three trials with high efficacy and low toxicity, has revolutionized treatment options.METHODS: In this study, representatives of the Tuberculosis Network European Trialsgroup (TBnet) in 44/54 countries of the WHO Europe region document the availability of the medicines and drug susceptibility testing (DST) of the BPaL(M) regimen through a structured questionnaire between September to November 2023.RESULTS: 24/44 (54.5%), 42/44 (95.5%), 43/44 (97.7%), and 43/44 (97.7%) had access to pretomanid, bedaquiline, linezolid, and moxifloxacin, respectively. Overall, 23/44 (52.3%) had access to all the drugs composing the BPaL(M) regimen. 7/44 (15.9%), 28/44 (63.6%), 34/44 (77.3%) and 36/44 (81.8%) had access to DST for pretomanid, bedaquiline, linezolid and moxifloxacin, respectively. DST was available for all medicines composing the BPaL(M) regimen in 6/44 (13.6%) countries.CONCLUSION: Only in about half of the countries participating in the survey clinicians have access to all the BPaL(M) regimen drugs. In less than a fifth of countries, a complete DST is possible. Rapid scale up of DST capacity to prevent unnoticed spread of drug resistance and equal access to new regimens are urgently needed in Europe.
ISSN:1198743X
DOI:10.1016/j.cmi.2024.03.009