Efficacy and Tolerability of Concomitant Use of Bedaquiline and Delamanid for Multidrug- and Extensively Drug-Resistant Tuberculosis : A Systematic Review and Meta-Analysis

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The introduction of two novel drugs, bedaquiline and delamanid, has given hope for better and shorter treatments of drug-resistant tuberculosis. A systematic review was conducted to evaluate the efficacy and safety of concomitant bedaquiline and delamanid administration. Pooled estimates of World Health Organization-defined favorable treatment outcome and significant QTc-interval prolongation (QTc ≥500 ms or ≥60 ms increase from baseline) were calculated using a random-effects model. Thirteen studies including a total of 1031 individuals with multidrug-resistant/rifampicin-resistant tuberculosis who received bedaquiline and delamanid were included. The pooled estimate of favorable treatment outcome was 73.1% (95% confidence interval [CI]: 64.3-81.8%). Sputum culture conversion at 6 months ranged from 61% to 95%. Overall, the pooled proportion of QTc-prolongation was 7.8% (95% CI: 4.1-11.6%) and few cardiac events were reported (0.8%; n = 6/798). Rates of sputum culture conversion and favorable treatment outcome were high in patients treated concomitantly with bedaquiline and delamanid, and the treatment seemed tolerable with low rates of clinically significant cardiac toxicity.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:76

Enthalten in:

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 76(2023), 7 vom: 03. Apr., Seite 1328-1337

Sprache:

Englisch

Beteiligte Personen:

Holmgaard, Freja Breth [VerfasserIn]
Guglielmetti, Lorenzo [VerfasserIn]
Lillebaek, Troels [VerfasserIn]
Andersen, Åse Bengaard [VerfasserIn]
Wejse, Christian [VerfasserIn]
Dahl, Victor Naestholt [VerfasserIn]

Links:

Volltext

Themen:

78846I289Y
Antitubercular Agents
Bedaquiline
Delamanid
Diarylquinolines
Drug resistance
Journal Article
Meta-Analysis
Nitroimidazoles
OPC-67683
Oxazoles
Systematic Review
Systematic review
Tuberculosis

Anmerkungen:

Date Completed 05.04.2023

Date Revised 11.04.2023

published: Print

Citation Status MEDLINE

doi:

10.1093/cid/ciac876

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM348458606