June 18, 2018

New Drug Helps Patients Beat Drug Resistant TB

News from the 5th South African Tuberculosis Conference in Durban is that a new drug could change the fate of people with extensively drug-resistant TB (XDR-TB).

Health-e News reports that the death rate for XDR-TB patients fell to 27% after the introduction of the blockbuster anti-TB drug bedaquiline. Before the introduction of this drug, about half of XDR-TB patients would die.

“DR-TB comes in two forms. Multi-drug resistant TB (MDR-TB) is resistant to two of the most common anti-TB drugs and XDR-TB is resistant to four – leaving very few drugs available. DR-TB treatment has traditionally equated to taking a cocktail of old and toxic drugs for about two years. The side-effects of this treatment are often debilitating, for example deafness, but even if patients take all their pills religiously they have a very slim chance of being cured.

In 2013, South Africa made “a bold and innovative move” to introduce a brand-new drug into the TB programme, according to Dr Francesca Conradie, a DR-TB expert from the Southern African HIV Clinicians Society.

It was bold, she said, because bedaquiline’s manufacturer Janssen Pharmaceuticals had not completed the usually-required years of rigorous safety and efficacy testing. Early trials had shown promising results but health experts had safety concerns.

But because, with so few effective drugs available, patients were dying, the Department of Health made the decision to introduce it to a small number of patients as part of a compassionate access programme. In 2014, access was rapidly scaled up and now two thirds of people receiving bedaquiline are in South Africa.

“The reason other countries with DR-TB epidemics haven’t introduced bedaquiline in the same way we have simply comes down to a lack of political commitment,” said Conradie. “The South African government has put their money where mouth is and the result is we have much fewer people dying of DR-TB.”