Active TB Drug Safety and Monitoring (ADSM)
workshop: Strengthening ADSM management in
drug-resistant TB
The clinical management of adverse events (AE) has always been a challenge in the care for drug-resistant (DR)-TB patients. Recommendations from the OR experience have highlighted the need to strengthen aDSM specifically the five AEs of special interest which include myelosuppression, peripheral neuropathy, optic neuropathy, hepatotoxicity, and QT prolongation, to ensure the safety of patients from the treatment regimen. This propelled the LIFT-TB project to conduct a workshop which would help address this challenge through the expertise of clinical specialists such as a hematologist, neurologist, neuro-ophthalmologist, hepatologist, and cardiologist. Preparations prior to the workshop entailed frequent and close collaborative meetings with the specialists to discuss their technical inputs ensuring technical feasibility and operational practicality of recommendations in the field.
The workshop was held at Sequoia Hotel Manila Bay Paranaque on 14-15 December 2023 attended by 76 participants including representatives from the OR sites, Research Team, TB Medical Advisory Committee (TBMAC) Chairs and Co-chairs, CHD (Centers for Health Development) Coordinators, local representatives and relevant partners. The event was opened by Dr Fides Buenafe, Division Chief of the DOH Pharmaceutical Division which was followed by Rationale and mechanics presented by Dr Mamel Quelapio (LIFT-TB Consultant, TBA and KNCV) and Dr Irene Flores (BPaL Principal Investigator). The technical sessions on 14 December included a presentation from Dr Mark Magdaluyo (neuro-ophthalmologist) on optic neuropathy, Dr Tom Suratos (neurologist – nerve and muscle specialist) on peripheral neuropathy, Dr Jesus Relos (hematologist) on myelosuppression. On 15 December, presentations were made by Dr Eternity Labio (gastroenterologist - hepatologist) on hepatotoxicity and Dr Paul Quetua (cardiologist -electrophysiologist) on QT prolongation. Demonstrations were made by Dr. Magdaluyo on the proper conduct of visual acuity and color vision testing, and by Dr. Suratos on the Brief Peripheral Neuropathy Screen (BPNS). After each session, representatives from OR sites presented actual cases encountered in the field which were tackled by the respective clinicians. A Q&A session followed each of the AE segments. A recap of the discussion and recommendations were provided by Dr Flores after each session.
The workshop was well received by the participants especially from the field implementers validating the success of the event. A synthesis of the workshop will be made by the LIFT-TB team and presented to the Disease Prevention and Control Bureau (DOH) as part of the project’s commitment to support the programmatic expansion of BPaL-based regimens.
LIFT-TB is supported by TB Alliance in partnership with the KNCV Tuberculosis Foundation, International Tuberculosis Research Center, and the Tropical Disease Foundation, Inc.
