Efficacy, safety and tolerability of linezolid containing regimens in treating MDR-TB and XDR-TB: systematic review and meta-analysis

Linezolid is used off-label to treat multidrug-resistant tuberculosis (MDR-TB) in absence of systematic evidence. We performed a systematic review and meta-analysis on efficacy, safety and tolerability of linezolid-containing regimes based on individual data analysis. 12 studies (11 countries from t...

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Vydáno v:The European respiratory journal Ročník 40; číslo 6; s. 1430
Hlavní autoři: Sotgiu, Giovanni, Centis, Rosella, D'Ambrosio, Lia, Alffenaar, Jan-William C, Anger, Holly A, Caminero, Jose A, Castiglia, Paolo, De Lorenzo, Saverio, Ferrara, Giovanni, Koh, Won-Jung, Schecter, Giesela F, Shim, Tae S, Singla, Rupak, Skrahina, Alena, Spanevello, Antonio, Udwadia, Zarir F, Villar, Miquel, Zampogna, Elisabetta, Zellweger, Jean-Pierre, Zumla, Alimuddin, Migliori, Giovanni Battista
Médium: Journal Article
Jazyk:angličtina
Vydáno: England 01.12.2012
Témata:
Acetamides - pharmacology
Adolescent
Adult
Antitubercular Agents - pharmacology
Extensively Drug-Resistant Tuberculosis - drug therapy
Female
Humans
Linezolid
Male
Middle Aged
Oxazolidinones - pharmacology
Patient Safety
Sputum - metabolism
Treatment Outcome
Tuberculosis, Multidrug-Resistant - drug therapy
ISSN:1399-3003, 1399-3003
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Shrnutí:Linezolid is used off-label to treat multidrug-resistant tuberculosis (MDR-TB) in absence of systematic evidence. We performed a systematic review and meta-analysis on efficacy, safety and tolerability of linezolid-containing regimes based on individual data analysis. 12 studies (11 countries from three continents) reporting complete information on safety, tolerability, efficacy of linezolid-containing regimes in treating MDR-TB cases were identified based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Meta-analysis was performed using the individual data of 121 patients with a definite treatment outcome (cure, completion, death or failure). Most MDR-TB cases achieved sputum smear (86 (92.5%) out of 93) and culture (100 (93.5%) out of 107) conversion after treatment with individualised regimens containing linezolid (median (inter-quartile range) times for smear and culture conversions were 43.5 (21-90) and 61 (29-119) days, respectively) and 99 (81.8%) out of 121 patients were successfully treated. No significant differences were detected in the subgroup efficacy analysis (daily linezolid dosage ≤ 600 mg versus >600 mg). Adverse events were observed in 63 (58.9%) out of 107 patients, of which 54 (68.4%) out of 79 were major adverse events that included anaemia (38.1%), peripheral neuropathy (47.1%), gastro-intestinal disorders (16.7%), optic neuritis (13.2%) and thrombocytopenia (11.8%). The proportion of adverse events was significantly higher when the linezolid daily dosage exceeded 600 mg. The study results suggest an excellent efficacy but also the necessity of caution in the prescription of linezolid.
Bibliografie:ObjectType-Article-1
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ISSN:1399-3003
1399-3003
DOI:10.1183/09031936.00022912