BACKGROUND: Current anti-tuberculosis therapeutics are not sufficiently effective against drug-resistant tuberculosis (DR-TB), and there is a need for new drugs and therapeutic approaches. It has been proposed that repurposing clofazimine for DR-TB treatment might be one way to increase therapeutic options. METHODS: We conducted a systematic review of studies reporting on the efficacy and safety of clofazimine as part of combination therapy for DR-TB. Six databases and six conference abstract sites were searched from inception until April 2012. All studies involving the use of clofazimine in the treatment of DR-TB were included. RESULTS: Twelve studies, comprising 3489 patients across 10 countries, were included in this review. Treatment success ranged from 16.5% (95% CI 2.7%-38.7%) to 87.8% (95% CI 76.8%-95.6%), with an overall pooled proportion of 61.96% achieving treatment success (95% CI 52.79%-71.12%) (τ(2) 0.07). Mortality, treatment interruptions, defaulting and adverse events were all in line with DR-TB treatment outcomes overall. The most commonly reported adverse events were gastrointestinal disturbances and skin pigmentation. CONCLUSIONS: The available evidence to date suggests that clofazimine could be considered as an additional therapeutic option in the treatment of DR-TB. The optimal dose of clofazimine and duration of use require further investigation.
BACKGROUND: Current anti-tuberculosis therapeutics are not sufficiently effective against drug-resistant tuberculosis (DR-TB), and there is a need for new drugs and therapeutic approaches. It has been proposed that repurposing clofazimine for DR-TB treatment might be one way to increase therapeutic options. METHODS: We conducted a systematic review of studies reporting on the efficacy and safety of clofazimine as part of combination therapy for DR-TB. Six databases and six conference abstract sites were searched from inception until April 2012. All studies involving the use of clofazimine in the treatment of DR-TB were included. RESULTS: Twelve studies, comprising 3489 patients across 10 countries, were included in this review. Treatment success ranged from 16.5% (95% CI 2.7%-38.7%) to 87.8% (95% CI 76.8%-95.6%), with an overall pooled proportion of 61.96% achieving treatment success (95% CI 52.79%-71.12%) (τ(2) 0.07). Mortality, treatment interruptions, defaulting and adverse events were all in line with DR-TB treatment outcomes overall. The most commonly reported adverse events were gastrointestinal disturbances and skin pigmentation. CONCLUSIONS: The available evidence to date suggests that clofazimine could be considered as an additional therapeutic option in the treatment of DR-TB. The optimal dose of clofazimine and duration of use require further investigation.
Authors: Nicole Salazar-Austin; Alvaro A Ordonez; Alice Jenh Hsu; Jane E Benson; Mahadevappa Mahesh; Elizabeth Menachery; Jafar H Razeq; Max Salfinger; Jeffrey R Starke; Aaron M Milstone; Nicole Parrish; Eric L Nuermberger; Sanjay K Jain Journal: Lancet Infect Dis Date: 2015-11-16 Impact factor: 25.071
Authors: Grania Brigden; Bern-Thomas Nyang'wa; Philipp du Cros; Francis Varaine; Jennifer Hughes; Michael Rich; C Robert Horsburgh; Carole D Mitnick; Eric Nuermberger; Helen McIlleron; Patrick P J Phillips; Manica Balasegaram Journal: Bull World Health Organ Date: 2013-10-25 Impact factor: 9.408
Authors: N Padayatchi; M Gopal; R Naidoo; L Werner; K Naidoo; I Master; M R O'Donnell Journal: J Antimicrob Chemother Date: 2014-06-30 Impact factor: 5.790
Authors: Sarah K Brode; Robert Varadi; Jane McNamee; Nina Malek; Sharon Stewart; Frances B Jamieson; Monica Avendano Journal: Can Respir J Date: 2014-12-10 Impact factor: 2.409