Bedaquiline and Delamanid's 'Payments Proper' for MDR-TB
Short-term treatment using oral medication only, and an operational research should be conducted...
With the announcement of a revised version of South Korea's multidrug-resistant tuberculosis guidelines just around the corner, research results on salary standards for related new drugs such as Bedaquiline and Delamanid have been released.
The conclusion is that both drugs are eligible for the treatment of all MDR-TB patients, but use other than permission is subject to expert review.
The Tuberculosis AIDS Management Department of the Korea Centers for Disease Control and Prevention recently released a research report titled "Professor Shim Tae-sun, a respiratory physician at Asan Medical Center in Seoul."
Currently, Korea restricts the use of new drugs only for MDR-TB, which cannot be treated with basic drugs alone, and a new drug pre-examination system is being implemented to this end.
However, recent guidelines by the World Health Organization recommend the use of new drugs in all MDR-TBs, raising the need to come up with measures to optimize the use of new drugs in local MDR-TB patients.
The study analyzed the treatment results for 814 MDR-TB patients who applied for the new drug pre-examination from September 2016 to November 2019.
The first new drugs out of 814 MDR-TB patients were: "Bdq," "Dlm," and "Both drugs" were 49.1 percent, 45.9 percent, and 4.9 percent, respectively, with simple MDR-TB, pre-XDR-TBIA, freeXDR-TB9.0 percent, and free-XDR-TBR-XD9.0 percent, respectively.
The average age was 52.3 years old, 69.2 percent for men and 8.4 percent for foreigners. There were four confirmed HIV infections. 47.0% were super-healing patients. The overall approval rate for new drugs was 86.1%.
24.1% applied for the sequential use of the two new drugs. By February 2018, the final treatment results from 269 people who applied for the screening were 56.9% for treatment success, 10.0% for death, 1.5% for treatment failure, 5.6% for discontinuation of treatment, and 25.7% for current treatment. Considering patients under treatment, Shim predicted that the final treatment success rate would be between 70 and 80%.
"On a comprehensive scale, the two new drugs should be used in the treatment of all MDR-TB patients," Professor Shim said. "Over 24 weeks, other than permission, such as children, and tuberculosis, should be used after expert review."
Lastly, Shim also suggested a direction to improve the system to fight multiple-resistant tuberculosis in Korea.
"In order to improve the treatment results, we need to establish a system of MDR-TB patient care so that we can not only choose the right medication, but also increase the treatment completion rate," he said. "Since the need for a long period of treatment still serves as a barrier to improving the treatment's success rate, short-term treatment using only oral medications should be implemented under an operational review."
