Interim treatment outcomes in multidrug-resistant tuberculosis using bedaquiline and/or delamanid in South Korea

Interim treatment outcomes in multidrug-resistant tuberculosis patients treated sequentially with bedaquiline and delamanid

“…For example, poorer outcomes in FQ-susceptible MDR-TB patients may have been associated with other clinical factors such as advanced age, interruptions in linezolid and new drug use due to ADR, and less frequent use of clofazimine and meropenem/ clavulanate than in FQ-resistant MDR-TB patients (Supplementary Material Table S2). However, other recent studies have shown that FQ resistance does not affect the treatment outcome in MDR-TB patients when treated with the new drugs (Kang et al, 2020;Schnippel et al, 2018;Lee et al, 2019).…”

“…In the study reported by Kim et al, 10 patients were treated sequentially with the new drugs, of whom seven (70%) achieved sputum culture conversion and one (10%) permanently discontinued new drug administration because of QT-prolongation (Kim et al, 2018). In a recent study reported by Kang et al, 67 patients were treated with both of the new drugs (seven concurrent use and 60 sequential use), among whom 58 (86.6%) obtained a favourable treatment outcome at 12 months (Kang et al, 2020). The present study enrolled a larger number of patients who were treated sequentially with the new drugs.…”

“…Bedaquiline (Bdq) and delamanid (Dlm), which are the only two available drugs that have been developed specifically for the treatment of MDR-TB in the past 40 years, have been shown to be efficacious and safe for MDR-TB, both in clinical trials and clinical practice (Gler et al, 2012;Skripconoka et al, 2013;Diacon et al, 2014;Pym et al, 2016;Borisov et al, 2017;Kim et al, 2018;Kang et al, 2020). These two new drugs received accelerated approval by stringent regulatory agencies after the completion of a phase 2B clinical trial; they were then recommended by the WHO for the treatment of MDR-TB, for only 24 weeks, in 2013 in the case of Bdq and 2014 in the case of Dlm (WHO, 2013;WHO, 2014).…”

“…QT interval prolongation on the electrocardiography, which can lead to cardiac arrhythmia, and also the long half-life of Bdq (WHO, 2019b;Guglielmetti et al, 2018a;Pontali et al, 2017a;Pontali et al, 2017b). A few studies on combination treatment with Bdq and Dlm have yielded promising results, but most of these have involved concurrent treatment with the two drugs (Kim et al, 2018;Kang et al, 2020;Maryandyshev et al, 2017;Ferlazzo et al, 2018;Pontali et al, 2018;Guglielmetti et al, 2018b;Hafkin et al, 2019;Olayanju et al, 2020).…”

Evaluating bedaquiline as a treatment option for multidrug-resistant tuberculosis

“…During the last year, several reports have shown the potential of combining BDQ other highly bactericidal drugs in order to shorten treatments, showing added cost-effectiveness [42][43][44][45][46][47]. Such evidence has moved the WHO to recommend shorter regimens based on a drug combination that takes into account different characteristics, especially oral administration and bactericidal/sterilizing activity (Table 1) [5].…”