WHO recommends shorter treatment regimens for drug-resistant tuberculosis

USA: The World Health Organization (WHO) has updated its guideline for the treatment of drug-resistant tuberculosis.In its updated released guideline on the treatment of drug-resistant tuberculosis (DR-TB), the World Health Organization (WHO), has called for a shorter drug course for resistant TB. 

The update includes shorter novel 6-month all-oral regimens for the treatment of multidrug- and rifampicin-resistant TB (MDR/RR-TB), with or without additional resistance to fluoroquinolones (pre-XDR-TB) as well as an alternative 9-month all-oral regimen for the treatment of MDR/RR-TB.

According to the rapid communication of WHO, all treatment should be delivered under WHO-recommended standards, including patient-centered care and support, informed consent where necessary, principles of good clinical practice, active drug safety monitoring and management, and regular monitoring of patients and of drug resistance to assess regimen effectiveness.

The Rapid Communication is released in advance of updated WHO consolidated guidelines expected later in 2022, to inform national TB programmes and other stakeholders of key changes in the treatment of DR-TB and to allow for rapid transition and planning at the country level.

"We now have more and much better treatment options for people with drug-resistant TB thanks to research generating new evidence. This is major progress compared to what was available even a few years ago, and will be of great benefit for people struggling with TB and drug-resistant TB, resulting in better outcomes, saving lives, and reducing suffering.", said Dr. Tereza Kasaeva, Director of WHO's Global TB Programme.

"We now need all hands on deck to enable the rapid uptake of these guidelines, and to enable access to the new treatment options for those in need."

To support countries in responding to the challenges of TB and DR-TB, including extensively drug-resistant TB (XDR-TB) and pre-XDR-TB, the WHO Global Tuberculosis Programme (regularly issues evidence-based guidelines using the international Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to the assessment of scientific evidence.

A Guideline Development Group was convened by WHO from 21 February to 25 March 2022 to review the new evidence on the treatment of drug-resistant TB that became available to WHO through national TB programs (NTPs), researchers and technical partners, and also from a WHO public call for data issued in June 2021. 

The guidance is based on evidence gathered in two phase 3 clinical trials—TB-PRACTECAL and ZeNIX—that found the BPaLM and BPaL regimens to be highly effective (89% cure rate and higher) in patients with MDR/RR-TB over the age of 15. The WHO convened an independent guideline development group (GDG) in February and March to review the evidence and update the guidelines accordingly.