Culture Conversion at 6 Months in Patients Receiving Delamanid-containing Regimens for the Treatment of Multidrug-resistant Tuberculosis

Seung, Kwonjune J.; Khan, Palwasha; Franke, Molly F; Ahmed, Saman; Aiylchiev, Stalbek; Alam, Manzur; Putri, Fauziah Asnely; Bastard, Mathieu; Docteur, Wisny; Gottlieb, Gary; Hewison, Catherine; Islam, Shirajul; Khachatryan, Naira; Kotrikadze, Tinatin; Khan, Uzma; Kumsa, Andargachew; Lecca, Leonid; Tassew, Yoseph; Melikyan, Nara; Naing, Ye Yint; Oyewusi, Lawrence; Rich, Michael; Wanjala, Stephen; Yedilbayev, Askar; Huerga, Helena; Mitnick, Carole D.

doi:10.1093/cid/ciz1084

Cited by 15 publications

(9 citation statements)

References 11 publications

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“…Six-month culture conversion was similarly high in both treatment regimens. Our findings compare well with those from other studies, reporting 6-month conversion rates between 87%-98% [ 8 , 24 – 27 ].…”

Section: Discussionsupporting

confidence: 92%

“…Mortality was higher among those treated with the individualized regimen, which is probably explained by the much higher frequency of baseline fluoroquinolone resistance in this cohort and concurrent co-morbidities. Indeed, initial fluoroquinolone resistance was a strong predictor of having an unfavorable outcome, which is coherent with other studies [10,21,[26][27][28][29][30]. After adjusting for initial fluoroquinolone resistance, severity of disease on chest radiography, and other confounders, the choice of regimen was not correlated with having an unfavorable outcome.…”

Section: Plos Onesupporting

confidence: 89%

“…both treatment regimens. Our findings compare well with those from other studies, reporting 6-month conversion rates between 87%-98% [8,[24][25][26][27]. Overall, RR-TB treatment was well tolerated and the frequency of AE was lower than in other studies [22].…”

Section: Plos Onesupporting

confidence: 88%

“…No patient developed treatment failure. Many patients had one or more known risk factors for delayed conversion [8,[24][25][26][27]. Despite 47.6% initially fluoroquinolone-resistant TB, a poor nutrition status in about half of our patients, and over 80% with advanced disease on chest radiography, almost all patients achieved six-month smear conversion.…”

Section: Plos Onementioning

confidence: 99%

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Translating drug resistant tuberculosis treatment guidelines to reality in war-torn Kandahar, Afghanistan: A retrospective cohort study

et al. 2020

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Introduction Afghanistan is affected by one of the world's longest protracted armed conflicts, frequent natural disasters, disease outbreaks and large population movements and it suffers from a high burden of tuberculosis (TB), including rifampicin-resistant TB (RR-TB). The study shows Mé decins Sans Frontières' experiences with care for patients with RR-TB in Kandahar Province. We describe the uptake of RR-TB treatment, how World Health Organisation criteria for the choice between the short and an individualized regimen were implemented, and treatment outcomes. Methods This is a retrospective cohort analysis of routinely collected data from RR-TB patients enrolled in care from 2016 until 2019. Descriptive analysis was performed to present characteristics of patients and treatment outcomes. Multivariable Cox analysis was performed to identify risk factors for having an unfavourable treatment outcome. Results Out of 146 enrolled RR-TB patients, 112 (76.7%) started treatment: 41 (36.6%) and 71 (63.4%) with the short and individualized treatment regimen, respectively. Of 82 with results for fluoroquinolone susceptibility, 39 (47.6%) had fluoroquinolone-resistant TB. Seven patients with initially fluoroquinolone-resistant TB and three pregnant women started the short regimen and 18 patients eligible for the short regimen started the injectable-free

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Section: Discussionsupporting

confidence: 92%

Section: Plos Onesupporting

confidence: 89%

Section: Plos Onesupporting

confidence: 88%

Section: Plos Onementioning

confidence: 99%

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Translating drug resistant tuberculosis treatment guidelines to reality in war-torn Kandahar, Afghanistan: A retrospective cohort study

et al. 2020

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“…(3)(4)(5)(6)(7) In 2012 and 2013, based on promising Phase II trial data, (8)(9)(10) stringent regulatory authorities approved the first new TB drugs in fifty years, bedaquiline (BDQ) and delamanid (DLM), offering hope for more effective and less toxic MDR-TB treatment. Since then, evidence generated from both randomized trials and observational studies has continued to support a role for these two drugs in MDR-TB treatment; (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) WHO has endorsed their use, gradually broadening the populations in which they might be used. ( TB).…”

Section: Introductionmentioning

confidence: 99%

Culture Conversion in Patients Treated with Bedaquiline and/or Delamanid. A Prospective Multicountry Study

Franke

Khan

Hewison

et al. 2021

Am J Respir Crit Care Med

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Background Bedaquiline and delamanid offer the possibility of more effective and less toxic multidrug-resistant tuberculosis (MDR-TB) treatment. With this treatment, however, some patients, remain at high risk for an unfavorable treatment outcome. The endTB observational study is the largest multicountry cohort of patients with rifampin-resistant/MDR-TB treated in routine care, according to WHO guidance, with delamanid-and/or bedaquiline-containing regimens. We report frequency of sputum culture conversion within six-months of treatment initiation and risk factors for non-conversion. Methods We included patients with a positive baseline culture who initiated a first endTB regimen prior to April 2018. Two consecutive negative cultures collected > 15 days apart constituted culture conversion. We used generalized mixed models to derive marginal predictions for the probability of culture conversion in key subgroups. Findings 1,109 patients initiated a multidrug treatment containing bedaquiline (63%), delamanid (27%) or both (10%). Of these, 939 (85%) experienced culture conversion within six months. In adjusted analyses, patients with HIV had a lower probability of conversion (0•73 [95% CI: 0•62, 0•84]) than patients without HIV (0•84 [95% CI: 0•79, 0•90]; p=0•03). Patients with both cavitary disease and highly positive sputum smear had a lower probability of conversion (0•68 [95% CI: 0•57, 0•79]) relative to patients without either (0•89; 95% CI: 0•84, 0•95; p=0•0004). Hepatitis C infection, diabetes mellitus/glucose intolerance, and baseline resistance were not associated with conversion.

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Atosiban and Rutin exhibit anti-mycobacterial activity - An integrated computational and biophysical insight toward drug repurposing strategy against Mycobacterium tuberculosis targeting its essential enzyme HemD

Sharma,

Muthu,

Agarwal

et al. 2023

International Journal of Biological Macromolecules

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Culture Conversion at 6 Months in Patients Receiving Delamanid-containing Regimens for the Treatment of Multidrug-resistant Tuberculosis

Cited by 15 publications

References 11 publications

Translating drug resistant tuberculosis treatment guidelines to reality in war-torn Kandahar, Afghanistan: A retrospective cohort study

Translating drug resistant tuberculosis treatment guidelines to reality in war-torn Kandahar, Afghanistan: A retrospective cohort study

Culture Conversion in Patients Treated with Bedaquiline and/or Delamanid. A Prospective Multicountry Study

Atosiban and Rutin exhibit anti-mycobacterial activity - An integrated computational and biophysical insight toward drug repurposing strategy against Mycobacterium tuberculosis targeting its essential enzyme HemD

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