Friday November 15, 2019

Tuberculosis (TB) Survivors at Higher Risk of Developing Lasting Damage to Lungs

According to the World Health Organisation's Global TB Report 2018, an estimated 2.8 million people have contracted TB in India

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Tuberculosis, Survivors, Lungs
Published in the Lancet Global Health, the study has found that more than one-third of patients who are successfully cured of TB with antibiotics developed permanent lung damage. Pixabay

Tuberculosis (TB) survivors, especially those living in India, are at a higher risk of developing lasting damage to lungs, according to a study done on more than 2,000 Indian patients.

Published in the Lancet Global Health, the study has found that more than one-third of patients who are successfully cured of TB with antibiotics developed permanent lung damage, which, in the worst cases, results in large holes in the lungs called cavities and widens the airways called bronchiectasis.

According to the World Health Organisation’s Global TB Report 2018, an estimated 2.8 million people have contracted TB in India which represents one quarter of all TB cases worldwide.

“This study calls urgent attention to the problem of post-TB lung damage worldwide. TB is a curable condition with antibiotics and great steps forward have been made towards eliminating the disease,” said study lead author James Chalmers, Professor at the University of Dundee.

Tuberculosis, Survivors, Lungs
Tuberculosis (TB) survivors, especially those living in India, are at a higher risk of developing lasting damage to lungs, according to a study done on more than 2,000 Indian patients.
Pixabay

“But this study is a wakeup call because even if we manage to eliminate all TB worldwide tomorrow, we are going to be left with a legacy of chronic lung damage and bronchiectasis which will require better recognition and better treatment,” he said.

For the study, the research team recruited 2,195 patients with established bronchiectasis from 14 Indian states.

TB survivors and patients with a history of severe infections such as childhood pneumonia made up the majority of patients with lung damage in India. The researchers found that these infections left a legacy of daily cough, further chest infections and poor quality of life.

Patients required further hospitalisations for treatment of their lung conditions in nearly 40 per cent of cases. Patients with post-TB lung damage had lost approximately 40 per cent of their lung capacity, leaving many patients with persistent breathlessness.

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Compared with patients in Europe and the US, those in India had more severe lung damage, lung function was worse and patients were more likely to be hospitalised for severe infections.

Recommended treatment for these patients such as inhalers, physiotherapy and antibiotic treatment for infections were rarely provided.

Physiotherapy exercises and antibiotics are inexpensive treatments which are proven to improve quality of life and reduce lung infections, but were available to less than 50 per cent of Indian patients.

The Indian government has pledged to eradicate TB by 2025, however this study warns that the TB epidemic could have lasting consequences for the treatment of lung conditions. (IANS)

Next Story

New Tuberculosis Treatment for 150 Countries Including India and South Africa to Cost $1,040

BPaL is an oral treatment which promises a shorter, more convenient option to existing TB treatment options, which use a cocktail of antibiotic drugs

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Tuberculosis, Treatment, Countries
A tuberculosis patient receives treatment at the TB Hospital in Gauhati, India, March 24, 2012. VOA

A newly approved three-drug treatment for tuberculosis will be available in 150 countries including India and South Africa, priced at $1,040 for a complete regimen, more than twice the cost proposed in the past by advocacy groups for other treatments.

The United Nations-backed Stop TB Partnership said on Monday that BPaL would be obtainable in eligible countries through the Global Drug Facility (GDF), a global provider of TB medicines created in 2001 to negotiate lower prices for treatments.

Tuberculosis was responsible for 1.5 million deaths in 2018.

BPaL is an oral treatment which promises a shorter, more convenient option to existing TB treatment options, which use a cocktail of antibiotic drugs over a period of up to two years.

Tuberculosis, Treatment, Countries
The United Nations-backed Stop TB Partnership said on Monday that BPaL would be obtainable in eligible countries through the Global Drug Facility (GDF), a global provider. Pixabay

The new cocktail, which will treat extensively drug-resistant strains of the illness, consists of drug developer TB Alliance’s newly-approved medicine pretomanid, in combination with linezolid and Johnson & Johnson’s bedaquiline.

Pretomanid, which will be available at $364 per treatment course, is only the third new medicine for drug-resistant tuberculosis to be approved in about 40 years, after J&J’s bedaquiline and Otsuka Pharmaceutical Co Ltd’s delamanid.

Criticism

Advocacy groups have long criticized the cost for bedaquiline and delamanid. Not-for-profit Medecins Sans Frontieres (MSF) has waged a running battle in public with J&J over its $400 price tag for a six-month course for bedaquiline.

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MSF has argued that bedaquiline could be produced and sold at a profit for 25 cents per day, and that the price of treatments for drug-resistant TB should be no higher than $500 for a complete treatment course.

Leena Menghaney, the South-Asia head for MSF’s Access Campaign, said it was a cause of concern that pretomanid was priced just below the price of bedaquiline.

But Stop TB Partnership says costs of other regimens for extremely drug-resistant TB range from $2,000 to $8,000 — for courses of at least 20 months.

Drugmakers

Tuberculosis, Treatment, Countries
Tuberculosis was responsible for 1.5 million deaths in 2018. Pixabay

TB Alliance in April granted a license to U.S. drugmaker Mylan NV to manufacture and sell pretomanid as part of certain regimens in high-income markets, as well as a non-exclusive license for low-income and middle-income countries, where most tuberculosis cases occur.

Stop TB Partnership said it would start supplying the regimen following World Health Organization’s guidance on using the drug. Mylan, however, said it will also sell the drug directly to countries.

Prices in low-income countries would be in-line with the price offered through GDF, but would be decided on a case by case basis where the drug is not supplied through GDF, it said.

The drug will be available in bottles of 26 tablets, with a six-month treatment requiring seven bottles.

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India-based Macleods Pharmaceuticals Ltd has also been granted a non-exclusive license to make pretomanid as part of the BPaL regimen, TB Alliance said Monday.

The maker of generic drugs will market the treatment in about 140 countries with high tuberculosis rates. (VOA)