To explore the implementation of shorter all-oral multidrug-resistant tuberculosis (MDR-TB) regimens in the UK and the practical barriers overcome in this process.
Key Findings:
Pretomanid prescribing increased fivefold from early 2024 to 2025.
Shorter regimens show favorable outcomes (84% to 93%) and are better tolerated than older regimens.
Implementation relied on expert oversight, funded access pathways, and monitoring guidance.
Interpretation:
The UK model demonstrates effective system design for safely and equitably implementing shorter MDR-TB regimens, emphasizing the importance of targeted therapeutics and standardized eligibility.
Limitations:
No systematic active drug safety monitoring scheme exists in the UK.
Trial populations were largely non-UK based.
Certain TB lineages may affect the efficacy of pretomanid.
Conclusion:
The UK experience provides a framework for other health systems to adopt shorter MDR-TB regimens, highlighting the need for coordinated efforts in drug approval, procurement, and monitoring.
