Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis

Brode, Sarah K.; Brust, James C.M.; Campbell, Jonathon R.; Chang, Vicky; Kempker, Russell R.; Udwadia, Zarir; Ahmad, Nafees; Baghaei, Parvaneh; Barkane, Linda; Benedetti, Andrea; Brode, S.K.; Brust, Jcm; Campbell, J. R.; Chang, Vwl; Falzon, Dennis; Guglielmetti, Lorenzo; Isaakidis, Petros; Kempker, R R; Kipiani, Maia; Kukša, Līga; Lan, Zhiyi; Lange, Christoph; Laniado-Laborı́n, Rafael; Nahid, Payam; Rodrigues, Denise; Singla, Rupak; Udwadia, Z F; Menzies, Dick

doi:10.1016/s2213-2600(20)30047-3

Cited by 183 publications

(161 citation statements)

References 58 publications

Supporting

Mentioning

140

Contrasting

Unclassified

Order By: Relevance

“…Occurrence of adverse events (AE) deemed “severe” varies between 5.6% and 48.2% in patients on STR [ 5 , 6 ]. Among drugs used in STR, second-line injectables have the highest risk of severe AE leading to treatment discontinuation (capreomycin (Cm) 8.2%, kanamycin (Km) 7.5%), while others have a lower risk (moxifloxacin (Mfx) 2.9%, clofazimine (Cfz) 1.6%, levofloxacin 1.3%) [ 7 ]. Irreversible hearing loss resulting from injectable use is one of the most debilitating events [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among drugs used in STR, second-line injectables have the highest risk of severe AE leading to treatment discontinuation (capreomycin (Cm) 8.2%, kanamycin (Km) 7.5%), while others have a lower risk (moxifloxacin (Mfx) 2.9%, clofazimine (Cfz) 1.6%, levofloxacin 1.3%) [ 7 ]. Irreversible hearing loss resulting from injectable use is one of the most debilitating events [ 7 , 8 ]. In a rapid communication, the WHO therefore recommended phasing out injectable drugs in favor of all-oral short or long individualised regimens containing bedaquiline, depending on baseline resistance [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Course of Adverse Events during Short Treatment Regimen in Patients with Rifampicin-Resistant Tuberculosis in Burundi

Ciza

Gils

Sawadogo

et al. 2020

JCM

View full text Add to dashboard Cite

The introduction of the nine-month short-treatment regimen (STR) has drastically improved outcomes of rifampicin-resistant tuberculosis (RR-TB) treatment. Adverse events (AE) commonly occur, including injectable-induced hearing loss. In Burundi we retrospectively assessed the frequency of adverse events and treatment modifications in all patients who initiated the STR between 2013–2017. Among 225 included patients, 93% were successfully treated without relapse, 5% died, 1% was lost-to-follow-up, 0.4% had treatment failure and 0.4% relapsed after completion. AE were reported in 53%, with grade 3 or 4 AE in 4% of patients. AE occurred after a median of two months. Hepatotoxicity (31%), gastro-intestinal toxicity (22%) and ototoxicity (10%) were most commonly reported. One patient suffered severe hearing loss. Following AE, 7% of patients had a dose reduction and 1% a drug interruption. Kanamycin-induced ototoxicity led to 94% of modifications. All 18 patients with a modified regimen were cured relapse-free. In this exhaustive national RR-TB cohort, RR-TB was treated successfully with the STR. Adverse events were infrequent. To replace the present STR, all-oral regimens should be at least as effective and also less toxic. During and after transition, monitoring, management, and documentation of AE will remain essential.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Course of Adverse Events during Short Treatment Regimen in Patients with Rifampicin-Resistant Tuberculosis in Burundi

Ciza

Gils

Sawadogo

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Concerns have been raised about safety and toxicity of linezolid. Critical adverse effects of linezolid include peripheral neuropathy, myelosuppression with consequent anemia and thrombocytopenia, and optic neuropathy leading to disability and blindness [ 44 ]. In a recent IPD-MA, the incidence of permanent discontinuation due to adverse effects of linezolid was 16.3% [ 44 ].…”

Section: Treatment Of Multidrug-resistant Tuberculosismentioning

confidence: 99%

“…Common adverse events include QT prolongation, nausea/vomiting, and arthralgia/myalgia. Severe adverse events were reported in 2.8% of the patients [ 44 ]. Bedaquiline is well absorbed, and its absorption increases with food.…”

Section: Treatment Of Multidrug-resistant Tuberculosismentioning

confidence: 99%

Diagnosis and treatment of multidrug-resistant tuberculosis

Jang¹,

Chung²

2020

Yeungnam Univ J Med

View full text Add to dashboard Cite

Tuberculosis (TB) is still a major health problem worldwide. Especially, multidrug-resistant TB (MDR-TB), which is defined as TB that shows resistance to both isoniazid and rifampicin, is a barrier in the treatment of TB. Globally, approximately 3.4% of new TB patients and 20% of the patients with a history of previous treatment for TB were diagnosed with MDR-TB. The treatment of MDR-TB requires medications for a long duration (up to 20–24 months) with less effective and toxic second-line drugs and has unfavorable outcomes. However, treatment outcomes are expected to improve due to the introduction of a new agent (bedaquiline), repurposed drugs (linezolid, clofazimine, and cycloserine), and technological advancement in rapid drug sensitivity testing. The World Health Organization (WHO) released a rapid communication in 2018, followed by consolidated guidelines for the treatment of MDR-TB in 2019 based on clinical trials and an individual patient data meta-analysis. In these guidelines, the WHO suggested reclassification of second-line anti-TB drugs and recommended oral treatment regimens that included the new and repurposed agents. The aims of this article are to review the treatment strategies of MDR-TB based on the 2019 WHO guidelines regarding the management of MDR-TB and the diagnostic techniques for detecting resistance, including phenotypic and molecular drug sensitivity tests.

show abstract

“…3 Neue WHO-Einteilung der Tuberkulosemedikamente [5]. Amikacin wird dabei für die Behandlung von erwachsenen Patienten mit einer MDR-/RR-TB nur empfohlen: ▪ wenn ein Therapieregime aus Medikamenten der Gruppen A und B nicht zusammengestellt werden kann, ▪ die Ergebnisse der Resistenztestung eine Wirksamkeit des Medikaments nahelegen und ▪ sichergestellt werden kann, dass ein engmaschiges Monitoring erfolgt, um die Entwicklung von Nebenwirkungen frühzeitig zu erkennen [40] Mehr als 10 % der Patienten, die mit Aminoglykosiden, PAS oder Linezolid wegen einer MDR-TB behandelt werden, erleiden Nebenwirkungen, die i. d. R. zum Wechsel der Therapie führen [41].…”

Section: Behandlung Der Tuberkulose Mit Isoniazid-monoresistenzunclassified

Die neuen WHO-Empfehlungen für schnelle Diagnostik und Therapie resistenter Tuberkulose in Deutschland, Österreich und der Schweiz

Otto-Knapp

Knappik²,

Häcker

et al. 2020

Pneumologie

View full text Add to dashboard Cite

ZusammenfassungDie erfreulicherweise zunehmende Evidenz hat in den letzten Jahren mehrfache Änderungen der internationalen Empfehlungen für die Diagnostik und Therapie der resistenten Tuberkulose notwendig gemacht. In diesem Jahr hat die WHO umfassende Empfehlungen veröffentlicht, die die Entwicklungen der letzten Jahre berücksichtigen. Die aktuelle deutsche Tuberkuloseleitlinie erschien im Jahr 2017 und weicht in einigen Bereichen von diesen Empfehlungen ab. Hier werden die Neuerungen der WHO-Empfehlungen von 2020 für schnelle Diagnostik und die Therapie resistenter Tuberkulose zusammengefasst und relevante Abweichungen für Deutschland, Österreich und die Schweiz kommentiert. Eine Neubewertung der Literatur findet derzeit im Rahmen der Aktualisierung der deutschsprachigen AWMF-2k-Leitlinie statt.

show abstract

Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis

Cited by 183 publications

References 58 publications

Course of Adverse Events during Short Treatment Regimen in Patients with Rifampicin-Resistant Tuberculosis in Burundi

Course of Adverse Events during Short Treatment Regimen in Patients with Rifampicin-Resistant Tuberculosis in Burundi

Diagnosis and treatment of multidrug-resistant tuberculosis

Die neuen WHO-Empfehlungen für schnelle Diagnostik und Therapie resistenter Tuberkulose in Deutschland, Österreich und der Schweiz

Contact Info

Product

Resources

About