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Bedaquiline + pretomanid + telacebec + moxifloxacin refers to an experimental four-drug combination regimen, commonly identified as BPaQM, being developed by Otsuka Pharmaceutical for the treatment of rifampicin-resistant (RR) and multidrug-resistant (MDR) pulmonary tuberculosis. The regimen is designed to shorten the standard treatment duration for resistant TB to approximately four months. It combines four distinct mechanisms of action: bedaquiline inhibits mycobacterial ATP synthase; pretomanid inhibits mycolic acid synthesis and acts as a respiratory poison; telacebec (or quabodepistat in the specific Otsuka BPaQM regimen) inhibits the DprE1 enzyme essential for cell wall synthesis; and moxifloxacin inhibits DNA gyrase and topoisomerase IV. This combination is currently being evaluated in Phase 3 clinical trials (such as NCT06042140) to assess its efficacy, safety, and tolerability in adults and adolescents with resistant forms of tuberculosis.
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