| Literature DB >> 28529205 |
Sergey E Borisov1,2, Keertan Dheda3,2, Martin Enwerem4,2, Rodolfo Romero Leyet5,2, Lia D'Ambrosio6,7,2, Rosella Centis6,2, Giovanni Sotgiu8,2, Simon Tiberi9,10,2, Jan-Willem Alffenaar11,2, Andrey Maryandyshev12,2, Evgeny Belilovski1,2, Shashank Ganatra13,2, Alena Skrahina14,2, Onno Akkerman15,16, Alena Aleksa17, Rohit Amale13, Janina Artsukevich17, Judith Bruchfeld18, Jose A Caminero19,20, Isabel Carpena Martinez21, Luigi Codecasa22, Margareth Dalcolmo23, Justin Denholm24, Paul Douglas25, Raquel Duarte26, Aliasgar Esmail27, Mohammed Fadul27, Alexey Filippov1, Lina Davies Forsman18, Mina Gaga28, Julia-Amaranta Garcia-Fuertes29, José-María García-García30, Gina Gualano31, Jerker Jonsson32, Heinke Kunst10, Jillian S Lau33, Barbara Lazaro Mastrapa34, Jorge Lazaro Teran Troya34, Selene Manga35, Katerina Manika36, Pablo González Montaner37, Jai Mullerpattan13, Suzette Oelofse27, Martina Ortelli38, Domingo Juan Palmero37, Fabrizio Palmieri31, Antonella Papalia39, Apostolos Papavasileiou40, Marie-Christine Payen41, Emanuele Pontali42, Carlos Robalo Cordeiro43, Laura Saderi8, Tsetan Dorji Sadutshang44, Tatsiana Sanukevich17, Varvara Solodovnikova14, Antonio Spanevello45,46, Sonam Topgyal44, Federica Toscanini47, Adrian R Tramontana48, Zarir Farokh Udwadia13, Pietro Viggiani39, Veronica White49, Alimuddin Zumla50, Giovanni Battista Migliori51,2.
Abstract
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.Entities:
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Year: 2017 PMID： 28529205 DOI： 10.1183/13993003.00387-2017
Source DB: PubMed Journal: Eur Respir J ISSN： 0903-1936 Impact factor: 16.671