Can Bedaquiline kill all Mycobacterium tuberculosis?

Bedaquiline tablets (Bedaquiline) is an anti-tuberculosis drug used to treat multidrug-resistant tuberculosis (MDR-TB). Although bedaquiline tablets play an important role in treating tuberculosis, they do not kill all tuberculosis bacteria. When understanding the efficacy of bedaquiline tablets, clinical trial data and its use in the treatment of tuberculosis need to be considered.

The efficacy of bedaquiline tablets is mainly achieved by inhibiting the ATP synthase (ATP synthase) of Mycobacterium tuberculosis. This drug inhibits the growth and replication processes of bacteria by interfering with their energy metabolism. However, bedaquiline tablets are not effective against all types of Mycobacterium tuberculosis, but are highly active against multidrug-resistant Mycobacterium tuberculosis (MDR-TB).

Clinical trial data show that bedaquiline tablets have significant efficacy in the treatment of multidrug-resistant tuberculosis. A key study was the U.S. Food and Drug Administration's (FDA) approval of two clinical trials of bedaquiline tablets, called "TMC207-C208" and "TMC207-C209" . The results of these trials showed that patients who received bedaquiline tablets in addition to standard treatment achieved significant improvements in treatment success compared with patients who received standard treatment alone.

In theTMC207-C208 trial, the treatment success rate was 57% in the group using bedaquiline tablets plus standard treatment, while the treatment success rate in the group using standard treatment alone was 31%. Similarly, in the TMC207-C209 trial, the treatment success rate was 66% in the arm that received bedaquiline tablets plus standard treatment, compared with 28% in the arm that received standard treatment alone. These results indicate that the addition of bedaquiline tablets can significantly improve the cure rate of multidrug-resistant tuberculosis.

However, despite its positive results in the treatment of multidrug-resistant tuberculosis, bedaquiline tablets do not eliminate all tubercle bacilli. Mycobacterium tuberculosis is a complex bacterium with multiple defense mechanisms and drug-resistant mutation capabilities. These properties make Mycobacterium tuberculosis challenging to treat with drugs, and resistance can emerge even when powerful drugs such as bedaquiline tablets are used.

In addition, the use of bedaquiline tablets needs to be combined with other anti-tuberculosis drugs to form a combined treatment regimen. The aim of this combination therapy is to reduce the development of drug resistance and increase the efficacy of the treatment. According to the recommendations of the World Health Organization (WHO), combined treatment regimens usually include multiple drugs, such as isoniazid, rifampicin, pyrazinamide, ampicillin, etc.

To summarize, bedaquiline tablets are an important drug for the treatment of multidrug-resistant tuberculosis, which works by inhibiting the ATP synthase of Mycobacterium tuberculosis. Clinical trial data show that when bedaquiline tablets are combined with standard treatment regimens, the success rate in treating multidrug-resistant tuberculosis is significantly improved. However, due to the complexity of Mycobacterium tuberculosis and the development of drug resistance, bedaquiline tablets cannot kill all types of Mycobacterium tuberculosis. Combination therapy remains the most effective way to fight TB and reduce the development of drug resistance. Therefore, the use of bedaquiline tablets should be done under the supervision of a doctor and follow a complete treatment regimen.

Bedaquiline tablets have been launched in China and have been included in Class B medical insurance. Patients can buy it domestically, but the price is very high. The price of 100mg*24tablets is around 15,000 yuan. For specific prices, please consult the local hospital pharmacy. There are only original drugs abroad, and the more cost-effective ones are Russian original drugs. The price of 100mg*188 tablets is also about 15,000 yuan. The specifications are about 8 times that of domestic ones. Relatively speaking, the price is still very cheap compared to domestic ones. And the ingredients of domestic and foreign original drugs are consistent.