TY - JOUR
T1 - Availability of drugs and resistance testing for BPaLM regimen for rifampicin-resistant tuberculosis in Europe
AU - Tuberculosis Network European Trials group
AU - Günther, Gunar
AU - Guglielmetti, Lorenzo
AU - Kherabi, Yousra
AU - Duarte, Raquel
AU - Lange, Christoph
AU - Adamides, Tonia
AU - Akkerman, Onno
AU - Andersen, Aase Bengaard
AU - Bakos, Ágnes
AU - Bjarnason, Agnar
AU - Bruchfeld, Judith
AU - Chesov, Dumitru
AU - Codecasa, Luigi Ruffo
AU - Cirillo, Daniela
AU - Danilovits, Manfred
AU - Davidavičienė, Edita
AU - Duarte, Raquel
AU - De Souza Galvão, Maria Luiza
AU - Garnier, Sandrine
AU - Gjocaj, Majlinda
AU - Günther, Gunar
AU - Ibraim, Elmira
AU - Kappnik, Michael
AU - Khachatryan, Naira
AU - Klimuk, Dzmitry
AU - Kuksa, Liga
AU - Jachym, Mathilde Frechet
AU - Josefsdottir, Kamilla
AU - Kaluzhenina, Anna
AU - Lange, Christoph
AU - Mack, Ulrich
AU - Makek, Mateja Jankovic
AU - Manika, Katerina
AU - Mclaughlin, Anne-Marie
AU - Mema, Donika
AU - Mengshoel, Anne Torunn
AU - Muylle, Inge
AU - Nanovic, Zorica
AU - Özkara, Şeref
AU - Perl, Sivan
AU - Pesut, Dragica
AU - Pierdou, Despo
AU - Ryskulov, Galym
AU - Skowroński, Marcin
AU - Solovic, Ivan
AU - Sukholytka, Mariia
AU - Svetina, Petra
AU - Terleeva, Yana
AU - Tiberi, Simon
AU - Togonidze, Tamara
AU - Zhdanova, Elena
N1 - Copyright © 2024 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
PY - 2024/9
Y1 - 2024/9
N2 - 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.
AB - 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.
U2 - 10.1016/j.cmi.2024.03.009
DO - 10.1016/j.cmi.2024.03.009
M3 - Article
C2 - 38490355
SN - 1198-743X
VL - 30
SP - 1197.e1-1197.e4
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 9
ER -