BACKGROUND AND SIGNIFICANCE: Treatment of multidrug-resistant tuberculosis (MDR-TB) is challenging because of the toxicity of second-line medications. Little is known about whether adverse events impact treatment outcome. METHODS: We conducted a retrospective case series of 244 MDR-TB patients enrolled in Tomsk between 10 September 2000 and 10 September 2002. Adverse reactions were determined by laboratory data and/or clinical criteria. A multiple logistic regression model was performed to determine whether the occurrence of adverse reactions was associated with poor treatment outcome. RESULTS: In this cohort, 76.0% were cured, 6.6% failed, 4.9% died and 11.5% defaulted. Adverse events were observed in 73.3% of patients, occurring in 74.8% of patients who were adherent (taking at least 80% of prescribed doses) and 59.1% of non-adherent individuals (P = 0.11). The impact of adverse events on outcome was modified by non-adherence; among adherent patients, the occurrence of any adverse reaction was associated with treatment cure (adjusted odds ratio 3.24, 95% confidence interval 1.56-6.70). CONCLUSION: Adverse reactions occurred frequently in MDR-TB patients in Tomsk, Russia, but did not negatively impact treatment outcome. The occurrence of adverse reactions among adherent patients was associated with treatment cure.
BACKGROUND AND SIGNIFICANCE: Treatment of multidrug-resistant tuberculosis (MDR-TB) is challenging because of the toxicity of second-line medications. Little is known about whether adverse events impact treatment outcome. METHODS: We conducted a retrospective case series of 244 MDR-TB patients enrolled in Tomsk between 10 September 2000 and 10 September 2002. Adverse reactions were determined by laboratory data and/or clinical criteria. A multiple logistic regression model was performed to determine whether the occurrence of adverse reactions was associated with poor treatment outcome. RESULTS: In this cohort, 76.0% were cured, 6.6% failed, 4.9% died and 11.5% defaulted. Adverse events were observed in 73.3% of patients, occurring in 74.8% of patients who were adherent (taking at least 80% of prescribed doses) and 59.1% of non-adherent individuals (P = 0.11). The impact of adverse events on outcome was modified by non-adherence; among adherent patients, the occurrence of any adverse reaction was associated with treatment cure (adjusted odds ratio 3.24, 95% confidence interval 1.56-6.70). CONCLUSION: Adverse reactions occurred frequently in MDR-TB patients in Tomsk, Russia, but did not negatively impact treatment outcome. The occurrence of adverse reactions among adherent patients was associated with treatment cure.
Authors: M Buziashvili; V Mirtskhulava; M Kipiani; H M Blumberg; D Baliashvili; M J Magee; J J Furin; N Tukvadze; R R Kempker Journal: Int J Tuberc Lung Dis Date: 2019-09-01 Impact factor: 2.373
Authors: Ma Tarcela Gler; Ruffy Guilatco; Janice C Caoili; Julia Ershova; Peter Cegielski; John L Johnson Journal: Am J Trop Med Hyg Date: 2013-09-09 Impact factor: 2.345
Authors: A C Miller; I Y Gelmanova; S Keshavjee; S Atwood; G Yanova; S Mishustin; J J Furin; S S Shin Journal: Int J Tuberc Lung Dis Date: 2012-04-09 Impact factor: 2.373
Authors: James C M Brust; N Sarita Shah; Theo L van der Merwe; Sheila Bamber; Yuming Ning; Moonseong Heo; Anthony P Moll; Marian Loveday; Umesh G Lalloo; Gerald H Friedland; Neel R Gandhi Journal: J Acquir Immune Defic Syndr Date: 2013-04-01 Impact factor: 3.731
Authors: Zhiyi Lan; Nafees Ahmad; Parvaneh Baghaei; Linda Barkane; Andrea Benedetti; Sarah K Brode; James C M Brust; Jonathon R Campbell; Vicky Wai Lai Chang; Dennis Falzon; Lorenzo Guglielmetti; Petros Isaakidis; Russell R Kempker; Maia Kipiani; Liga Kuksa; Christoph Lange; Rafael Laniado-Laborín; Payam Nahid; Denise Rodrigues; Rupak Singla; Zarir F Udwadia; Dick Menzies Journal: Lancet Respir Med Date: 2020-03-17 Impact factor: 30.700
Authors: Gustavo E Velásquez; Mercedes C Becerra; Irina Y Gelmanova; Alexander D Pasechnikov; Askar Yedilbayev; Sonya S Shin; Yevgeny G Andreev; Galina Yanova; Sidney S Atwood; Carole D Mitnick; Molly F Franke; Michael L Rich; Salmaan Keshavjee Journal: Clin Infect Dis Date: 2014-04-11 Impact factor: 9.079
Authors: Kwonjune J Seung; David B Omatayo; Salmaan Keshavjee; Jennifer J Furin; Paul E Farmer; Hind Satti Journal: PLoS One Date: 2009-09-25 Impact factor: 3.240