Mumbai: Over 1,000 patients with drug-resistant tuberculosis in Mumbai started a new drug combination that reduced the treatment period to six months from the usual 18–24 months.The BMC started the BPaL-M regimen—a 4-drug combination of bedaquiline, pretomanid, linezolid, and moxifloxacin (not all patients need mox)—in March 2025. “Till end-Nov, 1,093 eligible patients were put on the BPaL-M regimen,” said BMC executive health officer Dr Daksha Shah.She added that 89 patients successfully completed the treatment in Mumbai so far.The BPaL-M regimen was first approved by the US Food and Drug Administration in 2019, but India introduced it in the National TB Elimination Programme in March 2025 after a 2-year trial; however, 5 Centres of Excellence, including JJ Hospital, started it in Dec 2024.Doctors called the BPaL regimen a game-changer because the shorter treatment led to greater patient compliance. “I have patients who saw their siblings undergo 18-month-long treatment and suffer side effects. As they did not suffer many of those side effects, they are happy with the six-month option,” said pulmonologist Dr Vikas Oswal, who works with the BMC at its Shatabadi Hospital in Chembur and is a member of the national technical expert committee on TB.However, both Dr Shah and Dr Oswal said that BPaL-M cannot be given to all patients with drug-resistant TB. “Patient selection is to be done carefully. It works best for those with pulmonary TB and cannot be given to a patient with, say, spine TB,” said Dr Oswal.The BMC holds sessions with private practitioners to explain the criteria for BPaL-M; doctors have to refer patients to the govt sector for free BPaL-M drugs, as they are not sold at pharmacies.The city records 4,500 to 5,000 new cases of drug-resistant TB every year, along with 60,000 cases of drug-sensitive TB.
