{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:06:12Z","timestamp":1789538772622,"version":"build-2803163510"},"reference-count":22,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJTLD Open"],"accepted":{"date-parts":[[2026,5,19]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Clinical 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\u2019s national experience with BPaLM\/BPaL, focusing on treatment outcomes and adverse drug events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Thirty-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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>BPaLM\/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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/ijtldopen.26.0269","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:50:26Z","timestamp":1789537826000},"page":"586-591","source":"Crossref","is-referenced-by-count":0,"title":["Real-world treatment outcomes and adverse events during BPaLM therapy for rifampicin-resistant TB"],"prefix":"10.5588","volume":"3","author":[{"given":"C.V.","family":"Choong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.P.","family":"Soh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.Y.","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.X.","family":"Tay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.H.L.","family":"Khoong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.E.L.","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.B.E.","family":"Chee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"2026091522501967000_3.9.586.1","unstructured":"World Health Organization . Global tuberculosis report, 2025. Geneva: World Health Organization, 2025."},{"issue":"4","key":"2026091522501967000_3.9.586.2","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S2213-2600(20)30047-3","article-title":"Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis","volume":"8","author":"Lan","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2026091522501967000_3.9.586.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2019.10.003"},{"key":"2026091522501967000_3.9.586.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1901814"},{"key":"2026091522501967000_3.9.586.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2119430"},{"issue":"2","key":"2026091522501967000_3.9.586.6","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S2213-2600(23)00389-2","article-title":"Short oral regimens for pulmonary rifampicin-resistant tuberculosis (TB-PRACTECAL): an open-label, randomised, controlled, phase 2B-3, multi-arm, multicentre, non-inferiority trial","volume":"12","author":"Nyang\u2019wa","year":"2024","journal-title":"Lancet Respir Med"},{"issue":"10366","key":"2026091522501967000_3.9.586.7","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1016\/S0140-6736(22)02078-5","article-title":"Evaluation of two short standardised regimens for the treatment of rifampicin-resistant tuberculosis (STREAM stage 2): an open-label, multicentre, randomised, non-inferiority trial","volume":"400","author":"Goodall","year":"2022","journal-title":"Lancet"},{"key":"2026091522501967000_3.9.586.8","doi-asserted-by":"crossref","first-page":"100408","DOI":"10.1016\/j.jctube.2023.100408","article-title":"The use of BPaL containing regimen in the MDR\/PreXDR TB treatments in Thailand","volume":"34","author":"Sangsayunh","year":"2024","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"key":"2026091522501967000_3.9.586.9","doi-asserted-by":"crossref","first-page":"100472","DOI":"10.1016\/j.jctube.2024.100472","article-title":"Experiences in the introduction of bedaquiline pretomanid linezolid for drug-resistant tuberculosis in Kyrgyzstan","volume":"36","author":"Myrzaliev","year":"2024","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"issue":"11","key":"2026091522501967000_3.9.586.10","doi-asserted-by":"crossref","first-page":"e0310773","DOI":"10.1371\/journal.pone.0310773","article-title":"Introducing BPaL: experiences from countries supported under the LIFT-TB project","volume":"19","author":"Wares","year":"2024","journal-title":"PLoS One"},{"issue":"11","key":"2026091522501967000_3.9.586.11","doi-asserted-by":"crossref","first-page":"508","DOI":"10.5588\/ijtldopen.24.0369","article-title":"Experience of piloting BPaLM\/BPaL for DR-TB care at selected sites in Pakistan","volume":"1","author":"Khan","year":"2024","journal-title":"IJTLD Open"},{"issue":"4","key":"2026091522501967000_3.9.586.12","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1093\/cid\/ciaf214","article-title":"Effectiveness of the bedaquiline, pretomanid, and linezolid regimen, with or without moxifloxacin, for drug-resistant tuberculosis in Ukraine under programmatic conditions","volume":"81","author":"Dahl","year":"2025","journal-title":"Clin Infect Dis"},{"key":"2026091522501967000_3.9.586.13","unstructured":"World Health Organization . WHO consolidated guidelines on tuberculosis. Module 4: treatment - drug-resistant tuberculosis treatment, 2022 update."},{"issue":"2","key":"2026091522501967000_3.9.586.14","first-page":"2011804","article-title":"New treatment outcome definitions for drug-susceptible and drug-resistant tuberculosis: update from World Health Organization","volume-title":"Eur. Respir. J.","volume":"58","author":"Nguyen","year":"2021"},{"issue":"3","key":"2026091522501967000_3.9.586.15","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1093\/cid\/ciad653","article-title":"The safety and tolerability of linezolid in novel short-course regimens containing bedaquiline, pretomanid, and linezolid to treat rifampicin-resistant tuberculosis: an individual patient data meta-analysis","volume":"78","author":"Hasan","year":"2024","journal-title":"Clin Infect Dis"},{"key":"2026091522501967000_3.9.586.16","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202410-2096ST"},{"key":"2026091522501967000_3.9.586.17","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00315-2025"},{"key":"2026091522501967000_3.9.586.18","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae388"},{"key":"2026091522501967000_3.9.586.19","doi-asserted-by":"crossref","unstructured":"Key updates to the treatment of drug-resistant tuberculosis. 2024. https:\/\/doi.org\/10.2471\/B09123.","DOI":"10.2471\/B09123"},{"key":"2026091522501967000_3.9.586.20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2503687"},{"issue":"9","key":"2026091522501967000_3.9.586.21","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/S2213-2600(25)00194-8","article-title":"Bedaquiline, delamanid, linezolid, and clofazimine for rifampicin-resistant and fluoroquinolone-resistant tuberculosis (endTB-Q): an open-label, multicentre, stratified, non-inferiority, randomised, controlled, phase 3 trial","volume":"13","author":"Guglielmetti","year":"2025","journal-title":"Lancet Respir Med"},{"key":"2026091522501967000_3.9.586.22","doi-asserted-by":"crossref","first-page":"108065","DOI":"10.1016\/j.ijid.2025.108065","article-title":"Can 6-month long regimens become the standardized treatment for MDR-TB globally?","volume":"160","author":"Davoli","year":"2025","journal-title":"Int J Infect Dis"}],"container-title":["IJTLD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.5588\/ijtldopen.26.0269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:50:29Z","timestamp":1789537829000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.theunion.org\/lookup\/doi\/10.5588\/ijtldopen.26.0269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":22,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,1]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.5588\/ijtldopen.26.0269"],"URL":"https:\/\/doi.org\/10.5588\/ijtldopen.26.0269","relation":{},"ISSN":["3005-7590"],"issn-type":[{"value":"3005-7590","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}