. According to this article, a regimen based on the antibiotics bedaquiline and linezolid given for eight weeks was non-inferior to the six-month standard of care. The mean treatment duration with the bedaquiline/linezolid regimen was 85 days, compared with 180 in the six-month regimen.
“There are these environmental issues around how currently drug-sensitive TB drugs are procured and purchased that we haven’t had to address because you haven’t had anything new [in several years],” she says. “Now we do and it’s a problem that has to be solved before we can probably have equitable access to the four-month regimen.”
As for future treatments, McKenna suggested it is possible that research has reached the limits of how short treatment for DS-TB can get with the existing crop of new and repurposed drugs. The next wave of drugs, including advantaged alternatives to existing TB drugs, might help shorten treatment duration, she said.
“I’m hoping within this decade we will know how low [in treatment days] we can go for DS-TB treatment,” she said. McKenna also pointed out that the WHO is trying to address how to balance the interplay between the cost and safety of future shortened DS-TB regimens. “WHO is doing a process right now to put together an update to their target regimen profile. It’s out for public comment. It tries to weigh some of these questions. The indicators are price, safety [and] duration. They try to come up with what are the ideal minimal, optimal scenarios to help guide developers,” she explained.