Impact of bedaquiline on treatment outcomes of multidrug-resistant tuberculosis in a high-burden country.


Journal

The European respiratory journal
ISSN: 1399-3003
Titre abrégé: Eur Respir J
Pays: England
ID NLM: 8803460

Informations de publication

Date de publication:
06 2021
Historique:
received: 01 07 2020
accepted: 23 11 2020
pubmed: 19 12 2020
medline: 6 7 2021
entrez: 18 12 2020
Statut: epublish

Résumé

Evaluation of novel anti-tuberculosis (TB) drugs for the treatment of multidrug-resistant (MDR)-TB continues to be of high interest on the TB research agenda. We assessed treatment outcomes in patients with pulmonary MDR-TB who received bedaquiline-containing treatment regimens in the Republic of Moldova, a high-burden MDR-TB country. We systematically analysed the SIMETB national electronic TB database and performed a retrospective propensity score-matched comparison of treatment outcomes in a cohort of patients with MDR-TB who started treatment during 2016-2018 with a bedaquiline-containing regimen (bedaquiline cohort) and a cohort of patients treated without bedaquiline (non-bedaquiline cohort). Following propensity score matching, 114 patients were assigned to each cohort of MDR-TB patients. Patients in the bedaquiline cohort had a higher 6-month sputum culture conversion rate than those in the non-bedaquiline cohort (66.7% Bedaquiline-based MDR-TB treatment regimens result in better disease resolution when compared with bedaquiline-sparing MDR-TB treatment regimens under programmatic conditions in a country with a high burden of MDR-TB.

Sections du résumé

BACKGROUND
Evaluation of novel anti-tuberculosis (TB) drugs for the treatment of multidrug-resistant (MDR)-TB continues to be of high interest on the TB research agenda. We assessed treatment outcomes in patients with pulmonary MDR-TB who received bedaquiline-containing treatment regimens in the Republic of Moldova, a high-burden MDR-TB country.
METHOD
We systematically analysed the SIMETB national electronic TB database and performed a retrospective propensity score-matched comparison of treatment outcomes in a cohort of patients with MDR-TB who started treatment during 2016-2018 with a bedaquiline-containing regimen (bedaquiline cohort) and a cohort of patients treated without bedaquiline (non-bedaquiline cohort).
RESULTS
Following propensity score matching, 114 patients were assigned to each cohort of MDR-TB patients. Patients in the bedaquiline cohort had a higher 6-month sputum culture conversion rate than those in the non-bedaquiline cohort (66.7%
CONCLUSIONS
Bedaquiline-based MDR-TB treatment regimens result in better disease resolution when compared with bedaquiline-sparing MDR-TB treatment regimens under programmatic conditions in a country with a high burden of MDR-TB.

Identifiants

pubmed: 33334942
pii: 13993003.02544-2020
doi: 10.1183/13993003.02544-2020
pii:
doi:

Substances chimiques

Antitubercular Agents 0
Diarylquinolines 0
bedaquiline 78846I289Y

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright ©ERS 2021.

Déclaration de conflit d'intérêts

Conflict of interest: D. Chesov has nothing to disclose. Conflict of interest: J. Heyckendorf reports personal fees for lectures from Chiesi, Gilead, Janssen and Lucane, outside the submitted work. Conflict of interest: S. Alexandru has nothing to disclose. Conflict of interest: A. Donica has nothing to disclose. Conflict of interest: E. Chesov has nothing to disclose. Conflict of interest: M. Reimann has nothing to disclose. Conflict of interest: V. Crudu has nothing to disclose. Conflict of interest: V. Botnaru has nothing to disclose. Conflict of interest: C. Lange reports personal fees for lectures from Chiesi, Gilead, Janssen, Lucane, Novartis, Oxoid, Berlin-Chemie and Thermo Fisher, personal fees for meeting attendance from Oxford Immunotec, outside the submitted work.

Auteurs

Dumitru Chesov (D)

Dept of Pneumology and Allergology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova dumitru.chesov@usmf.md.
Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.
German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany.

Jan Heyckendorf (J)

Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.
German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany.
Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany.

Sofia Alexandru (S)

National TB Reference Laboratory, Chiril Draganiuc Phthisiopneumology Institute, Chisinau, Republic of Moldova.

Ana Donica (A)

National TB Reference Laboratory, Chiril Draganiuc Phthisiopneumology Institute, Chisinau, Republic of Moldova.

Elena Chesov (E)

Dept of Pneumology and Allergology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova.
Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.

Maja Reimann (M)

Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.
German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany.

Valeriu Crudu (V)

National TB Reference Laboratory, Chiril Draganiuc Phthisiopneumology Institute, Chisinau, Republic of Moldova.

Victor Botnaru (V)

Dept of Pneumology and Allergology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova.

Christoph Lange (C)

Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.
German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany.
Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany.

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