To End Tuberculosis, India must Embrace Innovation: Lessons from the ZeNix Trial Results

Evaluating Improved Success Rate of Newer 6–9-month Treatment Regimen under Conditional Access Program in Patients with Drug-resistant Tuberculosis

“…We read with interest the editorial by Dr. D Behera entitled "To End Tuberculosis, India must Embrace Innovation: Lessons from the ZeNix Trial Results" in Volume 64, Issue 2 (April-June 2022) of Indian Journal of Chest diseases and Allied Sciences. 1 Dr. D Behera has very aptly quoted that the COVID-19 pandemic has shown us how innovations, research adoption, and implementation of research have helped various countries including India to tackle this global COVID-19 pandemic effectively and very fast. However, in this process, control of tuberculosis (TB), globally as well as in India, suffered and there was a significant reduction in the notification rate and probably an increase in the mortality of TB in India.…”

“…One of them as mentioned by Dr. Behera also is the bedaquiline, pretomanid, and linezolid (BPaL) regimen which has shown good results in different dosages and durations of linezolid in many trials including the ZeNix trial. 1 Currently, to achieve TB elimination by 2025 in India, it is very essential that we use the current year 2022, and the coming year 2023 very effectively otherwise we are definitely going to miss the target. In India, modified BPaL is being tried for pre extensively drug-resistant TB (pre-XDR TB) patients under a multicentric study coordinated by NIRT, Chennai, across various sites spread all over the country.…”

“…As also mentioned by Dr. Behera, it is reemphasized here that a regimen such as modified BPaL if found effective, could improve India's drug-resistant TB success rate, which at present is much lower than the average for the world and its contemporaries, varying between 36 and 46%. 1 The existing DR-TB therapies, which take 18-24 months and require follow-up throughout, are stretching the already overburdened healthcare system, especially in this era of the ongoing pandemic. A 6-month regimen might help streamline the delivery of DR-TB treatment drugs.…”