학술논문
Outcome of treatment of MDR-TB or drug-resistant patients treated with bedaquiline and delamanid: Results from a large global cohort
Document Type
article
Author
S. Koirala; S. Borisov; E. Danila; A. Mariandyshev; B. Shrestha; N. Lukhele; M. Dalcolmo; S.R. Shakya; S. Miliauskas; L. Kuksa; S. Manga; A. Aleksa; J.T. Denholm; H.B. Khadka; A. Skrahina; S. Diktanas; M. Ferrarese; J. Bruchfeld; A. Koleva; A. Piubello; G.S. Koirala; Z.F. Udwadia; D.J. Palmero; M. Munoz-Torrico; R. GC; G. Gualano; V.I. Grecu; I. Motta; A. Papavasileiou; Y. Li; W. Hoefsloot; H. Kunst; J. Mazza-Stalder; M.-C. Payen; O.W. Akkerman; E. Bernal; V. Manfrin; A. Matteelli; H. Mustafa Hamdan; M. Nieto Marcos; J. Cadiñanos Loidi; J.J. Cebrian Gallardo; R. Duarte; N. Escobar Salinas; R. Gomez Rosso; R. Laniado-Laborín; E. Martínez Robles; S. Quirós Fernandez; A. Rendon; I. Solovic; M. Tadolini; P. Viggiani; E. Belilovski; M.J. Boeree; Q. Cai; E. Davidavičienė; L.D. Forsman; J. De Los Rios; J. Drakšienė; A. Duga; S.E. Elamin; A. Filippov; A. Garcia; I. Gaudiesiute; B. Gavazova; R. Gayoso; V. Gruslys; J. Jonsson; E. Khimova; G. Madonsela; C. Magis-Escurra; V. Marchese; M. Matei; C. Moschos; B. Nakčerienė; L. Nicod; F. Palmieri; A. Pontarelli; A. Šmite; M.B. Souleymane; M. Vescovo; R. Zablockis; D. Zhurkin; J.-W. Alffenaar; J.A. Caminero; L.R. Codecasa; J.-M. García-García; S. Esposito; L. Saderi; A. Spanevello; D. Visca; S. Tiberi; E. Pontali; R. Centis; L. D'Ambrosio; M. van den Boom; G. Sotgiu; G.B. Migliori
Source
Pulmonology, Vol 27, Iss 5, Pp 403-412 (2021)
Subject
Language
English
ISSN
2531-0437
Abstract
The World Health Organization (WHO) recommends countries introduce new anti-TB drugs in the treatment of multidrug-resistant tuberculosis.The aim of the study is to prospectively evaluate the effectiveness of bedaquiline (and/or delamanid)- containing regimens in a large cohort of consecutive TB patients treated globally.This observational, prospective study is based on data collected and provided by Global Tuberculosis Network (GTN) centres and analysed twice a year.All consecutive patients (including children/adolescents) treated with bedaquiline and/or delamanid were enrolled, and managed according to WHO and national guidelines.Overall, 52 centres from 29 countries/regions in all continents reported 883 patients as of January 31st 2021, 24/29 countries/regions providing data on 100% of their consecutive patients (10–80% in the remaining 5 countries).The drug-resistance pattern of the patients was severe (>30% with extensively drug-resistant -TB; median number of resistant drugs 5 (3−7) in the overall cohort and 6 (4−8) among patients with a final outcome).For the patients with a final outcome (477/883, 54.0%) the median (IQR) number of months of anti-TB treatment was 18 (13−23) (in days 553 (385–678)). The proportion of patients achieving sputum smear and culture conversion ranged from 93.4% and 92.8% respectively (whole cohort) to 89.3% and 88.8% respectively (patients with a final outcome), a median (IQR) time to sputum smear and culture conversion of 58 (30−90) days for the whole cohort and 60 (30−100) for patients with a final outcome and, respectively, of 55 (30−90) and 60 (30−90) days for culture conversion.Of 383 patients treated with bedaquiline but not delamanid, 284 (74.2%) achieved treatment success, while 25 (6.5%) died, 11 (2.9%) failed and 63 (16.5%) were lost to follow-up.