Effectiveness and safety of bedaquiline-containing regimens in the treatment of MDR- and XDR-TB: a multicentre study

Large studies on bedaquiline used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) are lacking. This study aimed to evaluate the safety and effectiveness of bedaquiline-containing regimens in a large, retrospective, observational study conducted in 25 centres...

Full description

Saved in:

Bibliographic Details
Published in:	The European respiratory journal Vol. 49; no. 5
Main Authors:	Borisov, Sergey E, Dheda, Keertan, Enwerem, Martin, Romero Leyet, Rodolfo, D'Ambrosio, Lia, Centis, Rosella, Sotgiu, Giovanni, Tiberi, Simon, Alffenaar, Jan-Willem, Maryandyshev, Andrey, Belilovski, Evgeny, Ganatra, Shashank, Skrahina, Alena, Akkerman, Onno, Aleksa, Alena, Amale, Rohit, Artsukevich, Janina, Bruchfeld, Judith, Caminero, Jose A, Carpena Martinez, Isabel, Codecasa, Luigi, Dalcolmo, Margareth, Denholm, Justin, Douglas, Paul, Duarte, Raquel, Esmail, Aliasgar, Fadul, Mohammed, Filippov, Alexey, Davies Forsman, Lina, Gaga, Mina, Garcia-Fuertes, Julia-Amaranta, García-García, José-María, Gualano, Gina, Jonsson, Jerker, Kunst, Heinke, Lau, Jillian S, Lazaro Mastrapa, Barbara, Teran Troya, Jorge Lazaro, Manga, Selene, Manika, Katerina, González Montaner, Pablo, Mullerpattan, Jai, Oelofse, Suzette, Ortelli, Martina, Palmero, Domingo Juan, Palmieri, Fabrizio, Papalia, Antonella, Papavasileiou, Apostolos, Payen, Marie-Christine, Pontali, Emanuele, Robalo Cordeiro, Carlos, Saderi, Laura, Sadutshang, Tsetan Dorji, Sanukevich, Tatsiana, Solodovnikova, Varvara, Spanevello, Antonio, Topgyal, Sonam, Toscanini, Federica, Tramontana, Adrian R, Udwadia, Zarir Farokh, Viggiani, Pietro, White, Veronica, Zumla, Alimuddin, Migliori, Giovanni Battista
Format:	Journal Article
Language:	English
Published:	England 01.05.2017
Subjects:	Adult Antitubercular Agents - therapeutic use Carbapenems - therapeutic use Clofazimine - therapeutic use Cohort Studies Diarylquinolines - therapeutic use Drug Therapy, Combination Extensively Drug-Resistant Tuberculosis - drug therapy Female HIV Infections - complications Humans Linezolid - therapeutic use Male Middle Aged Patient Safety Retrospective Studies Sputum - metabolism Treatment Outcome Tuberculosis, Multidrug-Resistant - drug therapy
ISSN:	1399-3003, 1399-3003
Online Access:	Get more information
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Large studies on bedaquiline used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) are lacking. This study aimed to evaluate the safety and effectiveness of bedaquiline-containing regimens in a large, retrospective, observational study conducted in 25 centres and 15 countries in five continents.428 culture-confirmed MDR-TB cases were analysed (61.5% male; 22.1% HIV-positive, 45.6% XDR-TB). MDR-TB cases were admitted to hospital for a median (interquartile range (IQR)) 179 (92-280) days and exposed to bedaquiline for 168 (86-180) days. Treatment regimens included, among others, linezolid, moxifloxacin, clofazimine and carbapenems (82.0%, 58.4%, 52.6% and 15.3% of cases, respectively).Sputum smear and culture conversion rates in MDR-TB cases were 63.6% and 30.1%, respectively at 30 days, 81.1% and 56.7%, respectively at 60 days; 85.5% and 80.5%, respectively at 90 days and 88.7% and 91.2%, respectively at the end of treatment. The median (IQR) time to smear and culture conversion was 34 (30-60) days and 60 (33-90) days. Out of 247 culture-confirmed MDR-TB cases completing treatment, 71.3% achieved success (62.4% cured; 8.9% completed treatment), 13.4% died, 7.3% defaulted and 7.7% failed. Bedaquiline was interrupted due to adverse events in 5.8% of cases. A single case died, having electrocardiographic abnormalities that were probably non-bedaquiline related.Bedaquiline-containing regimens achieved high conversion and success rates under different nonexperimental conditions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1399-3003 1399-3003
DOI:	10.1183/13993003.00387-2017