Treatment outcomes among patients with drug-resistant tuberculosis managed with BPaL/BPaLM regimen in the Southeast Zone of Nigeria

Introduction: the treatment of multidrug-resistant tuberculosis (MDR-TB) has been challenging, often associated with life-threatening adverse events and poor treatment outcomes. The recent World Health Organization (WHO) recommendation of the BPaLM regimen, consisting of bedaquiline, pretomanid, linezolid, and moxifloxacin for treatment of pre-extensively drug-resistant tuberculosis (Pre-XDR) and rifampicin-resistant tuberculosis (MDR-TB/RR), has been shown to have favorable treatment outcomes. This study focused on the outcomes of patients managed with this regimen in the southeastern zone of Nigeria between November 2023 and October 2024, following approval by the National Tuberculosis and Leprosy Control Program (NTBLCP) in November 2023. Methods: patient demographic and clinical data were collected from DR-TB treatment registers, active drug safety monitoring forms (aDSM), and laboratory registers using an abstraction tool. Data were analyzed using descriptive statistics such as frequency and percentages for variables such as age, gender, adverse events, new and retreatment cases, treatment outcomes such as completed treatment, cured, loss to follow-up (LTFU), and death. Results: out of the 212 patients enrolled for treatment during the period, 202 patients were treated for MDR-TB/RR with BPaLM, while 10 were treated for Pre-XDR with BPaL. The TSR for the MDR-TB/RR category is 89%, while the TSR for the Pre-XDR category is 100%. More than 6.7% of the patients in the MDR-TB/RR category were LFTU, and another 6.7% died. Over 86% of the patients treated had no documentation for adverse events, while 54% of the MDR-TB/RR cases were new cases. Conclusion: using the BPaLM regimen for DR-TB treatment results in favorable patient outcomes.