Wednesday was a pivotal day in the life of Ukrainian doctor Volodymyr, as it was the last day he took a new treatment once morest drug-resistant tuberculosis, which has been described as a turning point in the battle once morest the disease.
In the past, the 25-year-old doctor from Kyiv was undergoing another treatment that was less effective by half and required a higher number of doses, which caused him neurological complications.
But these symptoms disappeared when he started his new treatment, which he underwent for only six months, compared to two years for the previous treatment.
“It was very easy,” Volodymyr, who preferred not to mention his fame, told AFP. And an x-ray he took on Wednesday showed that his body was free of any trace of tuberculosis.
He now plans to return to work next week following eight months of sick leave. “I can now live my life once more,” he said. Tuberculosis was at the top of the list of the most deadly infectious diseases in the world, before the arrival of Covid-19, with a death toll of one and a half million annually. Approximately 5% of cases are resistant to the antibiotics that doctors prescribe, making them difficult to treat. However, a new regimen of drugs, called “Bypal” because it combines three types of antibiotics – bedaquiline, protomanid and linezolid – has been described as a major advance since its approval by the Food and Drug Administration (FDA) in the United States in 2019.
encouraging results
Research in 2020 showed that the Bepal system cured more than 90% of patients, but there was a high rate of side effects associated with linezolid, including nerve pain or bone marrow suppression (a decrease in the production of cells responsible for immunity). .
However, a study published Wednesday in the “New England Journal of Medicine” changed the rules of the game: It showed that it is possible to reduce the dose of linezolid in half without reducing the effectiveness of the treatment significantly. A trial of 181 participants with drug-resistant tuberculosis was conducted in Russia, South Africa, Georgia and Moldova, countries with high rates of tuberculosis.
While taking 1,200 milligrams of linezolid over six months was effective in 93% of cases, this rate drops to 91% when the dose is halved, to 600 milligrams. In this trial, the number of participants with peripheral neuropathy, which causes nerve pain, fell from 38% to 24%, while the rate of bone marrow suppression decreased from 22% to 2%.
“This is the beginning of the end for drug-resistant tuberculosis,” Francesca Conrady of South Africa’s Witvatterrand University told AFP. “The earlier you treat tuberculosis, the lower the infection – it’s like Covid in many ways.”
‘big progress’
It’s also easier for patients to take PayPal: Whereas previous treatments can require taking 23 pills a day and up to 14,000 pills in total over two years, PayPal consists of five pills a day – less than 750. over the course of six months.
For Natalia Litvinenko, who oversaw PayPal’s treatments in Ukraine, the more manageable amount of pills makes it easier for patients displaced by war to continue treatment.
The World Health Organization said earlier this year that it would soon update its guidelines to recommend that most drug-resistant tuberculosis patients use Pipal with 600 milligrams of linezolid. Two experts in the field who were not involved in Wednesday’s study described the findings as a “significant advance”.
In an editorial in the New England Journal of Medicine, Jay Thwaites of Britain’s Oxford University and Nguyen Viet Nhung of the Vietnamese National Tuberculosis Control Program write in an editorial in the New England Journal of Medicine that the BAYPAL treatment is “one of the defining developments in scientific research on tuberculosis this century”.
These developments come at a time when the Covid pandemic has raised fears of several barriers to the fight once morest tuberculosis.