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Insignificant difference in culture conversion between bedaquiline-containing and bedaquiline-free all-oral short regimens for multidrug-resistant tuberculosis
- Source :
- International Journal of Infectious Diseases, Vol 111, Iss, Pp 138-147 (2021)
- Publication Year :
- 2021
-
Abstract
- Background Multidrug-resistant tuberculosis (MDR-TB) patients have been suffering long, ineffective, and toxic treatment until short-course injectable-free regimens emerged. However, the new WHO-recommended regimens might be less feasible in the real-world setting. Here, we evaluated two optimized all-oral short-course regimens in China. Methods From April 2019 to August 2020, we conducted a prospective nonrandomized controlled trial and consecutively included 103 MDR-TB patients diagnosed with pulmonary MDR-TB in Shenzhen, China. A 4-5 drug regimen of 9-12 months was tailored to the strain's resistance patterns, patients' affordability, and tolerance to drugs. This was an interim analysis, focusing on the early treatment period. Results 53.4% (55/103) of patients were prescribed linezolid, fluoroquinolone (FQ), clofazimine, cycloserine, and pyrazinamide, followed by a regimen in which clofazimine was replaced by bedaquiline (35/103, 34.0%). The culture conversion rate was 83.1% and 94.4% at two and four months, respectively, with no significant difference between bedaquiline-free and bedaquiline-containing cases and between FQ-susceptible and FQ-resistant cases. Among 41 patients who completed treatment, 40 (97.6%) patients had a favorable outcome and no relapse was observed. Peripheral neuropathy and arthralgia/myalgia were the most frequent AEs (56.3%, 58/103). 18 AEs caused permanent discontinuation of drugs, mostly due to pyrazinamide and linezolid. Conclusion Optimized all-oral short-course regimens showed satisfactory efficacy and safety in early treatment stage. Further research is needed to confirm these results.
- Subjects :
- Microbiology (medical)
safety
medicine.medical_specialty
Tuberculosis
Antitubercular Agents
Infectious and parasitic diseases
RC109-216
Clofazimine
chemistry.chemical_compound
Internal medicine
Tuberculosis, Multidrug-Resistant
medicine
Culture conversion
Humans
Multidrug-resistant
Prospective Studies
Diarylquinolines
clinical trials
treatment
business.industry
General Medicine
Pyrazinamide
Interim analysis
medicine.disease
Discontinuation
Regimen
Infectious Diseases
chemistry
tuberculosis
outcome
Bedaquiline
business
medicine.drug
Subjects
Details
- ISSN :
- 18783511
- Volume :
- 111
- Database :
- OpenAIRE
- Journal :
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
- Accession number :
- edsair.doi.dedup.....f00e7bb12ca8a3e04c255c77bdc3f444