Bedaquiline and delamanid in tuberculosis

Esposito, Susanna; Bianchini, Sonia; Blasi, Francesco

doi:10.1517/14656566.2015.1080240

Cited by 51 publications

(36 citation statements)

References 82 publications

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“…Shorter treatment duration through the use of new drugs, delaminid and bedaquiline [8,29] with higher efficacy, is likely to improve completion rates, speed up culture conversion and reduce duration of long hospitalisation in the future [10,[30][31][32]. A 12 month regimen has recently become a WHO recommended option for selected patients who are supported to achieve full adherence and have no additional resistance (eg: pyrazinamide) [33,34].…”

Section: Discussionmentioning

confidence: 99%

Drug resistant TB: UK multicentre study (DRUMS): Treatment, management and outcomes in London and West Midlands 2008–2014

Arnold

Cooke

Kon

et al. 2017

Journal of Infection

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Highlights: Treatment practices and outcomes for MDR-TB treatment in the UK are described.  Treatment success is high limited by adherence rather than microbiological failure.  Variations in public health practice and housing lead to long hospital admissions.  New models and infrastructure are required to reduce poor adherence.  New methods using whole genome sequencing are required to shorten hospitalisation. ABSTRACTObjectives: Detailed information regarding treatment practices and outcomes of MDR-TB treatment in the UK is required as a baseline for care improvements.Methods: 100 consecutive cases between 2008 and 2014 were reviewed retrospectively at 4 MDR-TB treatment centres in England to obtain information on drug treatment choices, hospital admission duration and outcomes for MDR-TB.

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Section: Discussionmentioning

confidence: 99%

Drug resistant TB: UK multicentre study (DRUMS): Treatment, management and outcomes in London and West Midlands 2008–2014

Arnold

Cooke

Kon

et al. 2017

Journal of Infection

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“…[5–7] Delamanid is a nitro-dihydro-imidazoxazole derivative with mycobacteria-specific antibacterial activity in vitro, without activity against Gram-positive or Gram-negative bacteria or intestinal flora. [8] The nitroimidazopyran derivative acts through the inhibition of the mycolic acid biosynthesis, thus preventing the formation of the mycobacterial cell envelope and secondly, facilitating better drug penetration. [8] …”

Section: Introductionmentioning

confidence: 99%

“…[8] The nitroimidazopyran derivative acts through the inhibition of the mycolic acid biosynthesis, thus preventing the formation of the mycobacterial cell envelope and secondly, facilitating better drug penetration. [8] …”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety, and tolerability of a 24-month treatment regimen including delamanid in a child with extensively drug-resistant tuberculosis

et al. 2016

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Rational:Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are emerging problems in several countries. These infections require long and expensive treatment regimens. Recently, 2 new drugs, bedaquiline and delamanid, have been approved in several countries for use in adults with severe, difficult-to-treat MDR-TB, and it has been suggested that they could also be administered to children with MDR-TB and limited treatment options. However, no study has been completed on their efficacy.Patient concerns:This report describes a 12-year-old child with XDR-TB who was cured after a 24-month therapy regimen, which included delamanid.Diagnoses:The patient showed progressive clinical deterioration after 5 months of treatment with the majority of anti-TB drugs available on the market.Interventions:After unsuccessfull treatment with several anti-TB drugs for 5 months, he was treated with a regimen including for 24 months.Outcomes:Direct smear microscopy of the gastric aspirates and gastric aspirate cultures for Mycobacterium tuberculosis became negative after only 1 week and remained persistently negative. During the 24-month treatment, all blood test results remained within the normal range, no adverse events were reported, and corrected QT interval was always normal. A clinical and laboratory control was performed 3 months after discontinuation of delamanid, and the other drugs did not reveal any modification of both general conditions as well as laboratory and radiological findings. The patient was considered cured.Lessons:The positive outcome associated with the favorable safety and tolerability profile showed that long-term therapy with delamanid can significantly contribute to treating apparently hopeless XDR-TB cases in children.

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“…During the past few years new drugs to treat MDR/XDR-TB have been developed following trials and, given their initial (although incomplete) efficacy data, they have received provisional approval while additional registration trials are still ongoing [16,17]. The updated pipeline of new drugs is reported in figure 1 [1].…”

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confidence: 99%

Bedaquiline and multidrug-resistant tuberculosis: a systematic and critical analysis of the evidence

et al. 2016

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@ERSpublications Systematic review of the available scientific evidence on the role of bedaquiline in new effective M/XDR-TB regimens http://ow.ly/V68ZFThe importance of adequately managing multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) cases for TB control and elimination are underlined in the new World Health Organization (WHO) "End TB Strategy" [1, 2] as part of pillar one (integrated, patient-centred care and prevention; element 2: treatment of all people with TB including drug-resistant TB, and patient support) and in the recently published "Framework towards TB elimination in low incidence countries" in its priority action 5 (optimise the prevention and care of drug-resistant TB) and the related background documents [3][4][5]. Furthermore, both in the End TB Strategy ( pillar 3: intensified research and innovation) and in the Framework towards TB elimination in low incidence countries ( priority action 7: invest in research and new tools) the need for new anti-TB drugs is strongly emphasised [1,3,6]. The reasons why new anti-TB drugs are needed are rather obvious if you look closely at the dimensions of the MDR-TB epidemic and the treatment successes achieved so far.Out of the 480 000 MDR-TB cases estimated by WHO to have occurred in 2014, only 123 000 (one quarter) have been diagnosed and notified [1]. Overall, 3.3% of new and 20% of retreatment cases harbour MDR-TB resistant strains of Mycobacterium tuberculosis, of whom 9.7% are proven to be XDR-TB [1]. The country with the highest prevalence of MDR-TB cases is Belarus (34% in new and 69% in retreatment cases), where 29% of the cases are reported to be XDR-TB [1,7].Treatment of MDR-TB and XDR-TB has proven, so far, to be long, expensive and difficult-to-manage, and unfortunately, its outcomes are suboptimal in most cohorts [8,9]. Although XDR-TB cases actually represent a relatively small proportion of all MDR-TB cases (9%), their treatment and management are significantly more challenging both for clinicians and national programmes [1]. Globally, treatment success of MDR-TB cases in the 2012 cohort was 50% (16% died, 16% were lost to follow-up, 10% failed, and 8% had no outcome information). Among the cases with a resistance pattern beyond XDR-TB the proportion of treatment success is unfortunately as low as 20%, with 49% failure and death [8,10].The design of an effective regimen to treat MDR-and XDR-TB is based on the stepwise use of second-line TB drugs whose choice needs to be guided by drug susceptibility testing (DST) [11][12][13]. Unfortunately, at the programmatic level neither the drugs needed nor the specific DST to test them are always available

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Bedaquiline and delamanid in tuberculosis

Cited by 51 publications

References 82 publications

Drug resistant TB: UK multicentre study (DRUMS): Treatment, management and outcomes in London and West Midlands 2008–2014

Drug resistant TB: UK multicentre study (DRUMS): Treatment, management and outcomes in London and West Midlands 2008–2014

Efficacy, safety, and tolerability of a 24-month treatment regimen including delamanid in a child with extensively drug-resistant tuberculosis

Bedaquiline and multidrug-resistant tuberculosis: a systematic and critical analysis of the evidence

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