WHO issues rapid communication on updated guidance for treatment of drug-resistant TB

A rapid communication released by the World Health Organization (WHO) Global Tuberculosis Programme has announced upcoming updates to the guidance on the treatment of drug-resistant tuberculosis (DR-TB).

These updates include shorter novel 6-month all-oral regimens for the treatment of multidrug- and rifampicin-resistant TB (MDR/RR-TB), with or without additional resistance to fluoroquinolones (pre-XDR-TB) as well as an alternative 9-month all-oral regimen for the treatment of MDR/RR-TB.

All treatment should be delivered under WHO-recommended standards, including patient-centred care and support, informed consent where necessary, principles of good clinical practice, active drug safety monitoring and management, and regular monitoring of patients and of drug resistance to assess regimen effectiveness.

“We now have more and much better treatment options for people with drug-resistant TB thanks to research generating new evidence. This is major progress compared to what was available even a few years ago, and will be of great benefit for people struggling with TB and drug-resistant TB, resulting in better outcomes, saving lives and reducing suffering.”, said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme.

“We now need all hands on deck to enable the rapid uptake of these guidelines, and to enable access to the new treatment options  for those in need.”

The Rapid Communication is released in advance of updated WHO consolidated guidelines expected later in 2022, to inform national TB programmes and other stakeholders of key changes in the treatment of DR-TB and to allow for rapid transition and planning at the country level.

Guideline development process

To support countries in responding to the challenges of TB and DR-TB, including extensively drug-resistant TB (XDR-TB) and pre-XDR-TB, the WHO Global Tuberculosis Programme (regularly issues evidence-based guidelines using the international Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assessment of scientific evidence.

A Guideline Development Group was convened by WHO from 21 February to 25 March 2022 to review the new evidence on the treatment of drug-resistant TB that became available to WHO through national TB programmes (NTPs), researchers and technical partners, and also from a WHO public call for data issued in June 2021.

The details of the regimens included in the review are available in this Rapid Communication.