Which is better, Delamanid or Bedaquiline?

Delamanid and bedaquiline are approved for multidrug-resistant tuberculosis (MDR-TB). Bedaquiline carries a black box warning of an increased risk of death compared with placebo, and the risks of QT prolongation and hepatotoxicity of bedaquiline and delamanid need to be determined.

One study evaluated 61 patients with MDR-TB who received bedaquiline, delamanid or a combination of both, either sequentially or in combination, over 1 month, in combination with regimens recommended by the World Health Organization. Among them, 49 are male and 12 are female. Forty-two (68.9%) patients had fluoroquinolone-resistant MDR-TB, and 16 (26.2%) patients had XDR-TB. The median (IQR) duration of treatment with bedaquiline and/or delamanid was 168 days, and 33 patients (54.1%) received linezolid for a median (IQR) duration of 673 days. Of the 55 patients who had positive sputum cultures at the start of treatment with bedaquiline and/or delamanid, 39 (70.9%) achieved negative sputum cultures within a median of 119 days. Bedaquiline and delamanid are effective and safe in the treatment of multidrug-resistant tuberculosis, and preliminary evidence suggests that sequential administration of these two drugs is a feasible treatment strategy when an appropriate treatment regimen cannot be established.

The original drug Delamani has been launched in China and is included in the scope of Class B medical insurance. Reimbursement is limited to patients with multi-drug-resistant tuberculosis. Specifications The price of each box of 50mg*60 tablets may be around RMB 6,000. The price of the Russian version of the original drug Dramani, 50mg*48 tablets, sold overseas may be around RMB 1,000-2,000 per box (the price may fluctuate due to the exchange rate). There is currently no generic version of Dramani available on the market. For more drug information and specific prices, please consult Yaode’s medical consultant.