Mumbai: At the state-run JJ Hospital in Byculla, 10 patients, including two teenagers, received early access to the much-awaited short regimen called BPaL for the deadly drug-resistant tuberculosis (MDR-TB). They have been on the treatment since late Dec 2024 and are showing improvement, said hospital doctors.
Thousands of MDR-TB patients in Mumbai and the rest of Maharashtra, though, will need to wait a bit longer until the first or second week of March for BPaL. The importance of BPaL, a combination of three antibiotics called bedaquiline, pretomanid, and linezolid, lies in the fact it is only a six-month-long treatment as against the existing 18 to 20 months that involves taking 14,000 oral pills and daily injections for six months. Studies done across the world say cure rates are high with BPaL, which has fewer side effects than the existing treatment.
The J J Hospital patients got BPaL earlier because the hospital is one of the five Centres of Excellence for drug-resistant TB treatment (two CoEs are in Delhi and one each in Chennai and Lucknow). “J J Hospital is the first in Maharashtra to have started the much-awaited treatment,” said a senior doctor from the public hospital. State TB officer Sandip Sangle is hopeful of the BPaL treatment being available to all patients over 14 years of age in early March.
“The medicines have been disbursed by the Centre. Over 50% of the state’s TB officials have undergone specialised training for the rollout, and we will be ready as soon as the remaining are trained too,” he said. BMC executive health officer Dr Daksha Shah said BPaL medicines are already in stock, and training of all TB officials in Mumbai is complete. “As soon as the medicines are distributed, we are ready to start,” she said.
Meanwhile, J J authorities said the hospital will soon start BPaL for children too. It will start 10 patients on the treatment soon. India has the highest burden of TB in the world, accounting for almost 26% of the global caseload and 26% of deaths. Central health officials decided to carry out a three-year-long clinical trial of BPaL, checking for efficacy and recurrence, even though many countries such as high-burden ones like South Africa, started BPaL years back.
Mumbai, considered to have the highest burden of TB, was the first to start the clinical trial with 100 patients in BMC-run Shatabdi Hospital in Govandi and Sarvodaya in Ghatkopar. Across India, 403 patients were on trial, with 352 declared cured at the end of 6 months. At the 12-month follow-up, 280 did not have TB, and 11 (4%) had a recurrence.