Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis

•MDR-TB is difficult to manage; updated clinical guidance of new drug use is needed•No recent systematic review/meta-analysis on delamanid (DLM) is available•In observational studies including DLM (591 patients) the success rate was 80.9%•In experimental studies including DLM (391 patients) the succ...

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Vydáno v:	International journal of infectious diseases Ročník 124; číslo Suppl 1; s. S90 - S103
Hlavní autoři:	Nasiri, Mohammad Javad, Zangiabadian, Moein, Arabpour, Erfan, Amini, Sirus, Khalili, Farima, Centis, Rosella, D'Ambrosio, Lia, Denholm, Justin T., Schaaf, H. Simon, van den Boom, Martin, Kurhasani, Xhevat, Dalcolmo, Margareth Pretti, Al-Abri, Seif, Chakaya, Jeremiah, Alffenaar, Jan-Willem, Akkerman, Onno, Silva, Denise Rossato, Muňoz-Torrico, Marcela, Seaworth, Barbara, Pontali, Emanuele, Saderi, Laura, Tiberi, Simon, Zumla, Alimuddin, Migliori, Giovanni Battista, Sotgiu, Giovanni
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Canada Elsevier Ltd 01.11.2022 Elsevier
Témata:	Antitubercular Agents - therapeutic use bedaquiline delamanid Diarylquinolines - therapeutic use effectiveness Humans MDR-TB Nitroimidazoles - therapeutic use Oxazoles - adverse effects safety Treatment Outcome Tuberculosis, Multidrug-Resistant - drug therapy effectiveness MDR-TB delamanid bedaquiline safety TB
ISSN:	1201-9712, 1878-3511, 1878-3511
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Abstract	•MDR-TB is difficult to manage; updated clinical guidance of new drug use is needed•No recent systematic review/meta-analysis on delamanid (DLM) is available•In observational studies including DLM (591 patients) the success rate was 80.9%•In experimental studies including DLM (391 patients) the success rate was 72.5%•Few adverse events attributable to DLM were reported Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis is available to comprehensively evaluate the role of delamanid (DLM), we evaluated its effectiveness and safety. We reviewed the relevant scientific literature published up to January 20, 2022. The pooled success treatment rate with 95% confidence intervals (CI) was assessed using a random-effect model. We assessed studies for quality and bias, and considered P<0.05 to be statistically significant. After reviewing 626 records, we identified 25 studies that met the inclusion criteria, 22 observational and 3 experimental, with 1276 and 411 patients, respectively. In observational studies the overall pooled treatment success rate of DLM-containing regimens was 80.9% (95% CI 72.6-87.2) with no evidence of publication bias (Begg's test; P >0.05). The overall pooled treatment success rate in DLM and bedaquiline-containing regimens was 75.2% (95% CI 68.1-81.1) with no evidence of publication bias (Begg's test; P >0.05). In experimental studies the pooled treatment success rate of DLM-containing regimens was 72.5 (95% CI 44.2-89.8, P <0.001, I2: 95.1%) with no evidence of publication bias (Begg's test; P >0.05). In MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events.
AbstractList	Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis is available to comprehensively evaluate the role of delamanid (DLM), we evaluated its effectiveness and safety.INTRODUCTIONMultidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis is available to comprehensively evaluate the role of delamanid (DLM), we evaluated its effectiveness and safety.We reviewed the relevant scientific literature published up to January 20, 2022. The pooled success treatment rate with 95% confidence intervals (CI) was assessed using a random-effect model. We assessed studies for quality and bias, and considered P<0.05 to be statistically significant.METHODSWe reviewed the relevant scientific literature published up to January 20, 2022. The pooled success treatment rate with 95% confidence intervals (CI) was assessed using a random-effect model. We assessed studies for quality and bias, and considered P<0.05 to be statistically significant.After reviewing 626 records, we identified 25 studies that met the inclusion criteria, 22 observational and 3 experimental, with 1276 and 411 patients, respectively. In observational studies the overall pooled treatment success rate of DLM-containing regimens was 80.9% (95% CI 72.6-87.2) with no evidence of publication bias (Begg's test; P >0.05). The overall pooled treatment success rate in DLM and bedaquiline-containing regimens was 75.2% (95% CI 68.1-81.1) with no evidence of publication bias (Begg's test; P >0.05). In experimental studies the pooled treatment success rate of DLM-containing regimens was 72.5 (95% CI 44.2-89.8, P <0.001, I2: 95.1%) with no evidence of publication bias (Begg's test; P >0.05).RESULTSAfter reviewing 626 records, we identified 25 studies that met the inclusion criteria, 22 observational and 3 experimental, with 1276 and 411 patients, respectively. In observational studies the overall pooled treatment success rate of DLM-containing regimens was 80.9% (95% CI 72.6-87.2) with no evidence of publication bias (Begg's test; P >0.05). The overall pooled treatment success rate in DLM and bedaquiline-containing regimens was 75.2% (95% CI 68.1-81.1) with no evidence of publication bias (Begg's test; P >0.05). In experimental studies the pooled treatment success rate of DLM-containing regimens was 72.5 (95% CI 44.2-89.8, P <0.001, I2: 95.1%) with no evidence of publication bias (Begg's test; P >0.05).In MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events.CONCLUSIONSIn MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events. •MDR-TB is difficult to manage; updated clinical guidance of new drug use is needed•No recent systematic review/meta-analysis on delamanid (DLM) is available•In observational studies including DLM (591 patients) the success rate was 80.9%•In experimental studies including DLM (391 patients) the success rate was 72.5%•Few adverse events attributable to DLM were reported Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis is available to comprehensively evaluate the role of delamanid (DLM), we evaluated its effectiveness and safety. We reviewed the relevant scientific literature published up to January 20, 2022. The pooled success treatment rate with 95% confidence intervals (CI) was assessed using a random-effect model. We assessed studies for quality and bias, and considered P<0.05 to be statistically significant. After reviewing 626 records, we identified 25 studies that met the inclusion criteria, 22 observational and 3 experimental, with 1276 and 411 patients, respectively. In observational studies the overall pooled treatment success rate of DLM-containing regimens was 80.9% (95% CI 72.6-87.2) with no evidence of publication bias (Begg's test; P >0.05). The overall pooled treatment success rate in DLM and bedaquiline-containing regimens was 75.2% (95% CI 68.1-81.1) with no evidence of publication bias (Begg's test; P >0.05). In experimental studies the pooled treatment success rate of DLM-containing regimens was 72.5 (95% CI 44.2-89.8, P <0.001, I2: 95.1%) with no evidence of publication bias (Begg's test; P >0.05). In MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events. Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis is available to comprehensively evaluate the role of delamanid (DLM), we evaluated its effectiveness and safety. We reviewed the relevant scientific literature published up to January 20, 2022. The pooled success treatment rate with 95% confidence intervals (CI) was assessed using a random-effect model. We assessed studies for quality and bias, and considered P<0.05 to be statistically significant. After reviewing 626 records, we identified 25 studies that met the inclusion criteria, 22 observational and 3 experimental, with 1276 and 411 patients, respectively. In observational studies the overall pooled treatment success rate of DLM-containing regimens was 80.9% (95% CI 72.6-87.2) with no evidence of publication bias (Begg's test; P >0.05). The overall pooled treatment success rate in DLM and bedaquiline-containing regimens was 75.2% (95% CI 68.1-81.1) with no evidence of publication bias (Begg's test; P >0.05). In experimental studies the pooled treatment success rate of DLM-containing regimens was 72.5 (95% CI 44.2-89.8, P <0.001, I : 95.1%) with no evidence of publication bias (Begg's test; P >0.05). In MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events. • MDR-TB is difficult to manage; updated clinical guidance of new drug use is needed • No recent systematic review/meta-analysis on delamanid (DLM) is available • In observational studies including DLM (591 patients) the success rate was 80.9% • In experimental studies including DLM (391 patients) the success rate was 72.5% • Few adverse events attributable to DLM were reported Introduction: Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis is available to comprehensively evaluate the role of delamanid (DLM), we evaluated its effectiveness and safety. Methods: We reviewed the relevant scientific literature published up to January 20, 2022. The pooled success treatment rate with 95% confidence intervals (CI) was assessed using a random-effect model. We assessed studies for quality and bias, and considered P<0.05 to be statistically significant. Results: After reviewing 626 records, we identified 25 studies that met the inclusion criteria, 22 observational and 3 experimental, with 1276 and 411 patients, respectively. In observational studies the overall pooled treatment success rate of DLM-containing regimens was 80.9% (95% CI 72.6-87.2) with no evidence of publication bias (Begg's test; P >0.05). The overall pooled treatment success rate in DLM and bedaquiline-containing regimens was 75.2% (95% CI 68.1-81.1) with no evidence of publication bias (Begg's test; P >0.05). In experimental studies the pooled treatment success rate of DLM-containing regimens was 72.5 (95% CI 44.2-89.8, P <0.001, I2: 95.1%) with no evidence of publication bias (Begg's test; P >0.05). Conclusions: In MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events.
Author	van den Boom, Martin Amini, Sirus Al-Abri, Seif Alffenaar, Jan-Willem Muňoz-Torrico, Marcela Migliori, Giovanni Battista Sotgiu, Giovanni Schaaf, H. Simon Denholm, Justin T. Kurhasani, Xhevat Tiberi, Simon Khalili, Farima Dalcolmo, Margareth Pretti Nasiri, Mohammad Javad Akkerman, Onno D'Ambrosio, Lia Arabpour, Erfan Chakaya, Jeremiah Silva, Denise Rossato Saderi, Laura Zumla, Alimuddin Seaworth, Barbara Centis, Rosella Zangiabadian, Moein Pontali, Emanuele
Author_xml	– sequence: 1 givenname: Mohammad Javad surname: Nasiri fullname: Nasiri, Mohammad Javad email: mj.nasiri@hotmail.com organization: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 2 givenname: Moein surname: Zangiabadian fullname: Zangiabadian, Moein email: zangiabadian1998@gmail.com organization: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 3 givenname: Erfan orcidid: 0000-0003-0557-1278 surname: Arabpour fullname: Arabpour, Erfan email: erfanarabpour1999@gmail.com organization: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 4 givenname: Sirus surname: Amini fullname: Amini, Sirus email: sirusamini@gmail.com organization: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 5 givenname: Farima surname: Khalili fullname: Khalili, Farima email: farimakhalili@yahoo.com organization: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 6 givenname: Rosella orcidid: 0000-0002-8551-3598 surname: Centis fullname: Centis, Rosella email: rosella.centis@icsmaugeri.it organization: Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy – sequence: 7 givenname: Lia orcidid: 0000-0002-7000-5777 surname: D'Ambrosio fullname: D'Ambrosio, Lia email: liadambrosio59@gmail.com organization: Public Health Consulting Group, Lugano, Switzerland – sequence: 8 givenname: Justin T. orcidid: 0000-0002-9214-6431 surname: Denholm fullname: Denholm, Justin T. email: justin.denholm@mh.org.au organization: Victorian Tuberculosis Program, Melbourne Health, Victoria, Australia – sequence: 9 givenname: H. Simon orcidid: 0000-0001-5755-4133 surname: Schaaf fullname: Schaaf, H. 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Keywords	effectiveness MDR-TB delamanid bedaquiline safety TB
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PublicationDate_xml	– month: 11 year: 2022 text: November 2022
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PublicationTitle	International journal of infectious diseases
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Publisher	Elsevier Ltd Elsevier
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Snippet	•MDR-TB is difficult to manage; updated clinical guidance of new drug use is needed•No recent systematic review/meta-analysis on delamanid (DLM) is... Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis is... • MDR-TB is difficult to manage; updated clinical guidance of new drug use is needed • No recent systematic review/meta-analysis on delamanid (DLM) is... Introduction: Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic...
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SubjectTerms	Antitubercular Agents - therapeutic use bedaquiline delamanid Diarylquinolines - therapeutic use effectiveness Humans MDR-TB Nitroimidazoles - therapeutic use Oxazoles - adverse effects safety Treatment Outcome Tuberculosis, Multidrug-Resistant - drug therapy
Title	Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis
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