Experience of Using Two Courses of Bedaquiline in the Adolescent With Extensive Drug Resistant Fibrous Cavernous Tuberculosis

Панова, Л.В.; Ovsyankina, E.S.; Khiteva, A.Yu.; Krushinskaya, Ekaterina

doi:10.21292/2075-1230-2019-97-7-56-60

Cited by 5 publications

(2 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Проблема лікування туберкульозу (ТБ) із множинною/ широкою лікарською стійкістю (МЛС/ШЛС) залишається актуальною у світі загалом і в Україні зокрема. Недостатня ефективність режимів хіміотерапії, що ґрунтуються на тради ційних протитуберкульозних препаратах (ПТП) другого ряду, та накопичення доказової бази щодо нових ПТП сприяли вдосконаленню схем лікування та створенню режимів із застосуванням нових антимікобактеріальних препаратів (АМБП), як-от бедаквілін (Bdq), деламанід (Dlm) і претоманід (Pa), як у дорослих, так і в дітей і підлітків [1][2][3][4][5][6][7][8][9][10][11][12]. Водночас триває пошук патогенетичних препаратів, які сприятимуть зменшенню побічних реакцій, що виникають у разі призначення ПТП, та дадуть можливість підвищити ефективність лікування хворих на ТБ легень (ТБЛ), особливо при розвитку резистентних форм специфічного процесу як у дорослих, так і в дітей і підлітків.…”

Section: вступunclassified

Evaluation of the effectiveness of immunomodulator BI-V in the complex therapy of children and adolescents with multiple drug-resistant pulmonary tuberculosis

Sakhelashvili-Bil,

Platonova

2023

View full text Add to dashboard Cite

BACKGROUND. The feasibility of combining antimycobacterial therapy (AMBT) with bedaquiline (Bdq) and delamanid (Dlm) with non-specific immunomodulator BI-V in children and adolescents with multidrug-resistant and rifampicin-resistant pulmonary tuberculosis (MDR/Rif-TBP) needs to be studied. OBJECTIVE. To find out the effectiveness of the use of complex AMBT with Bdq and Dlm with non-specific immunomodulator BI-V in children and adolescents with MDR/Rif-TBP. MATERIALS AND METHODS. Children and adolescents with MDR/Rif-TBP at the initial stage of AMBT were given BI-V (BIVEL, Slovenia) as a non-specific immunomodulator. The patients were divided into two groups: 1st – 20 patients who received Bdq + Dlm + levofloxacin (Lfx) + linezolid (Lzd) + clofazimine (Cfz); 2nd ‒ 28 patients whose complex treatment included BI-V (Вdq + Dlm + Lfx + Lzd + Cfz + BI-V). BI-V was prescribed from the age of 3 years at 5 ml suspension once a day during 24 days RESULTS. The use of BI-V against the background of individualized regimens of AMBT in children and adolescents with MDR/Rif-TBP increased the effectiveness of treatment, contributed to the disappearance of symptoms of intoxication, the resolution of infiltration foci and the healing of decay cavities in system of immune protection, which contributed to the shortening of the inpatient stage of treatment, while maintaining a high therapeutic effectiveness (“cured” ‒ 92.8 %) and the formation of small residual changes in the lungs in the majority (89.3 %). CONCLUSIONS. When using combined complex AMBT with Bdq, Dlm and BI-V, high therapeutic efficiency was observed in most patients (92.8 %).

show abstract

Section: вступunclassified

Evaluation of the effectiveness of immunomodulator BI-V in the complex therapy of children and adolescents with multiple drug-resistant pulmonary tuberculosis

Sakhelashvili-Bil,

Platonova

2023

View full text Add to dashboard Cite

show abstract

“…In the medical literature, a little number RI VWXGLHV LV GHYRWHG WR WKH LVVXH RI WKH H˜HFWLYHQHVV of the treatment of Bdq and Dlm among children and adolescents [8,9,13]. In this regard, it is important WR GHWHUPLQH WKH H˜HFWLYHQHVV DQG WROHUDELOLW\ of new AMDs in children and adolescents with MDR/XDR-TB.…”

mentioning

confidence: 99%

Evaluation of the effectiveness of bedaquiline and delamanid treatment among children and adolescents with multi-drug-resistant pulmonary tuberculosis

Sakhelashvili¹,

Platonova²,

Sakhelashvili–Bil³

et al. 2023

MPU

View full text Add to dashboard Cite

Introduction. Against the backdrop of multiple and widespread drug resistance of Mycobacterium tuberculosis (MDR-TB), there has been a significant decline in the effectiveness of treatment of tuberculosis (TB) patients in Ukraine and globally. Therefore, in recent years, new antimycobacterial drugs, such as bedaquiline (Bdq), delamanid (Dlm) and pretomanid, have been introduced to improve treatment efficacy in adults, children and adolescents. The purpose - to study the effectiveness of complex treatment with bedaquiline (Bdq) and delamanid (Dlm) in children under 18 years old with multiple and extensively drug-resistant pulmonary TB (MDR/XDR-TB). Materials and methods. To study the clinical efficacy of chemotherapy with Bdq and Dlm, a retrospective cohort analysis of medical records was conducted. The main group consisted of 40 children with MDR/XDR-TB who received comprehensive antimycobacterial therapy with Bdq and Dlm; and the control group consisted of 27 patients who received treatment without Bdq and Dlm. Results. It was found that during the first three months of treatment, there was a decrease in bacilli in all patients treated with Bdq and Dlm and in the group of patients without these new drugs (control), but in the control group, the decrease was significantly slower, p<0.05. According to the immune system parameters, after the intensive phase was completed, the activity of a specific process was 1.7 times more frequent in patients of the control group than in the main group. After completion of the course of treatment, all patients in the main group showed resorption of infiltration, compaction of foci, and formation of fibrosis in the lungs according to the results of X-ray tomographic examination. However, in 14.8% of patients in the control group, treatment failure was noted with the resumption of bacterial release and destruction in the lung tissue, and in the main group, all patients had healing of the decay cavities. In the majority (77.5%) of patients in the main group, treatment resulted in the formation of small residual changes, but large residual changes were 2.3 times more common in the control group in the form of multiple dense foci, fibrosis and residual decay cavities. Conclusions. Studies have shown the high efficacy of complex treatment with Bdq and Dlm in children and adolescents. In particular, in MDR/XDR-TB patients treated with Bdq and Dlm, treatment results were 2 times more likely to be considered “cured” than in the control group, and 1.5 times less likely to be considered “complete”. The treatment success rate in the main group was 100.0%, and in the control group - 85.2%. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

show abstract

Bedaquiline in the postoperative period of complex therapy of tuberculosis

Kondakova,

Kovaleva,

Tyarasova

et al. 2023

Medicinskij sovet

View full text Add to dashboard Cite

Introduction. The experience of domestic phthisiatry, which has been using bedaquiline for more than 10 years, testifies to the efficacy and safety of the drug for the treatment of drug-resistant forms of tuberculosis. At the present stage, the evaluation of the effect and safety of bedaquiline in the postoperative stage of chemotherapy, including patients with HIV/tuberculosis co-infection, becomes the most relevant.Aim. To evaluate the results of bedaquiline application in the postoperative stage of complex tuberculosis therapy.Materials and methods. Results of a retrospective study of medical records of 57 patients. The inclusion criterion was the surgery performed for tuberculosis and the presence of bedaquiline in the postoperative chemotherapy regimen. Frequency of tuberculosis progression 1 month after surgery was evaluated as an efficacy criterion. The frequency of QTc interval prolongation with clinical manifestations, frequency and nature of hepatotoxic reactions were evaluated as the drug safety criterion.Results. In the absolute majority of patients – 54 (94.7%) postoperative period, during which bedaquiline was used, proceeded without complications. Cases of tuberculosis progression were observed only in patients with severe concomitant diseases. Undesirable side effects on bedaquiline were observed in 9 (15.8%) patients, the absolute majority of patients resumed taking the drug in full after drug correction. The average duration of bedaquiline prescription was 282 ± 5 doses.Conclusions. The use of bedaquiline in the postoperative period increases the effectiveness of complex therapy and prevents progression of tuberculosis and according to our data should be regarded as safe. Administration of bedaquiline in patients with HIV/tuberculosis co-infection also contributes to the positive result of the therapy. Repeated courses of bedaquiline after surgical intervention, including in patients with HIV/tuberculosis co-infection, prevent progression of tuberculosis in the postoperative period. The tolerability of the bedaquiline-containing regimen in this category of patients, including long courses of more than 24 weeks, was assessed as quite satisfactory.

show abstract

Experience of Using Two Courses of Bedaquiline in the Adolescent With Extensive Drug Resistant Fibrous Cavernous Tuberculosis

Cited by 5 publications

References 1 publication

Evaluation of the effectiveness of immunomodulator BI-V in the complex therapy of children and adolescents with multiple drug-resistant pulmonary tuberculosis

Evaluation of the effectiveness of immunomodulator BI-V in the complex therapy of children and adolescents with multiple drug-resistant pulmonary tuberculosis

Evaluation of the effectiveness of bedaquiline and delamanid treatment among children and adolescents with multi-drug-resistant pulmonary tuberculosis

Bedaquiline in the postoperative period of complex therapy of tuberculosis

Contact Info

Product

Resources

About