ArticleIJTLD open2026
Real-world treatment outcomes and adverse events during BPaLM therapy for rifampicin-resistant TB.
Article in IJTLD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
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Abstract
backgroundClinical trials have demonstrated high efficacy of bedaquiline, pretomanid, and linezolid with or without moxifloxacin (BPaLM/BPaL) for rifampicin-resistant and multidrug-resistant TB (RR/MDR-TB), but real-world implementation data remain limited, particularly from South-East Asian programmatic settings. We report Singapore's national experience with BPaLM/BPaL, focusing on treatment outcomes and adverse drug events.
methodsWe conducted a retrospective analysis of all RR/MDR-TB patients treated with BPaLM/BPaL at the National Tuberculosis Care Centre (NTBCC), Singapore, between July 2022 and September 2025. Data on demographics, microbiology, treatment characteristics, adverse drug reactions, and outcomes were extracted from a standing database.
resultsThirty-three patients were included (median age 39 years, 45.4% men). Over half were asymptomatic at diagnosis, and 90.9% had culture-confirmed disease. All patients who completed treatment locally achieved treatment success without any relapses observed during available follow-up. Adverse drug reactions requiring regimen modification occurred in 21 patients (63.6%). Moxifloxacin was discontinued for 14 patients (42.4%), predominantly due to QTc prolongation and gastrointestinal intolerance while 11 patients (33.3%) required linezolid dose reduction due to haematological toxicity and peripheral neuropathy.
conclusionsBPaLM/BPaL achieved excellent early effectiveness but required frequent regimen modifications. Successful implementation of short-course RR/MDR-TB regimens requires anticipatory toxicity monitoring, flexible regimen management, and robust treatment support systems.
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