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- Title
Efficacy and Tolerability of Concomitant Use of Bedaquiline and Delamanid for Multidrug- and Extensively Drug-Resistant Tuberculosis: A Systematic Review and Meta-Analysis.
- Authors
Holmgaard, Freja Breth; Guglielmetti, Lorenzo; Lillebaek, Troels; Andersen, Åse Bengaard; Wejse, Christian; Dahl, Victor Naestholt
- Abstract
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.
- Subjects
SPUTUM microbiology; DRUG efficacy; ONLINE information services; WORLD Health Organization; CARDIOTOXICITY; COMBINATION drug therapy; META-analysis; MEDICAL information storage &; retrieval systems; CONFIDENCE intervals; SYSTEMATIC reviews; LONG QT syndrome; TREATMENT effectiveness; COMPARATIVE studies; ANTITUBERCULAR agents; DESCRIPTIVE statistics; MEDLINE; EVALUATION
- Publication
Clinical Infectious Diseases, 2023, Vol 76, Issue 7, p1328
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciac876