Rationale for continuation of Moxifloxacin in BPaLM regimen irrespective of FQ resistance

Rationale for continuation of Moxifloxacin in BPaLM regimen irrespective of FQ resistance

Mfx is a part of BPaLM regimen for full course, irrespective of resistance pattern to FQ at baseline or during the course of the regimen. The following are the supporting evidence for continuation of Moxifloxacin in BPaLM regimen irrespective of FQ resistance pattern:

TB PRACTECAL study (Ref.: Lancet Respiratory Medicine Feb 2024):TB PRACTECAL trial had 3 arms including BPaLM, BPaLC, BPaL compared with the WHO standard of care. In the BPaLM arm 32/138 participants (23%) were FQ resistant and Mfx continued throughout the treatment duration in all 138 patients irrespective of FQ resistance status.

• Faster culture conversion
• Low recurrence and probable protection against amplification of bedaquiline resistance
• Better treatment outcome
• Comparable time to culture conversion
• The safety outcomes also favoured BPaLM.
• The QTcF interval at week 24 was lower in the BPaLM group than in the standard-care group and more closely resembled the QTcF in the BPaL group.