Treatment outcomes 24 months after initiating short, all-oral bedaquiline-containing or injectable-containing rifampicin-resistant tuberculosis treatment regimens in South Africa: a retrospective cohort study

Ndjeka, Norbert; Campbell, Jonathon R.; Meintjes, Graeme; Maartens, Gary; Schaaf, H. Simon; Hughes, Jennifer; Padanilam, Xavier; Reuter, Anja; Romero, Rodolfo; Ismail, Farzana; Enwerem, Martin; Ferreira, Héverson Batista; Conradie, Francesca; Naidoo, Kogieleum; Menzies, Dick

doi:10.1016/s1473-3099(21)00811-2

Cited by 31 publications

(20 citation statements)

References 22 publications

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“…Several studies conducted in other countries have reported that the use of new drugs has contributed to a reduction in TB deaths. 18 19 20 However, in the present study, the treatment success rate marginally decreased since 2015, concurrent with the availability of new drugs in Korea. In a recent study, new drug-containing regimens achieved a treatment success of 79.1% but also presented an all-cause death of 11.9%.…”

Section: Discussionmentioning

confidence: 48%

Nationwide Treatment Outcomes of Patients With Multidrug/Rifampin-Resistant Tuberculosis in Korea, 2011–2017: A Retrospective Cohort Study (Korean TB-POST)

et al. 2023

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Background The treatment outcomes of patients with multidrug/rifampin-resistant (MDR/RR) tuberculosis (TB) are important indicators that reflect the current status of TB management and identify the key challenges encountered by TB control programs in a country. Methods We retrospectively evaluated the treatment outcomes as well as predictors of unfavorable outcomes in patients with MDR/RR-TB notified from 2011 to 2017, using an integrated TB database. Results A total of 7,226 patients with MDR/RR-TB were included. The treatment success rate had significantly increased from 63.9% in 2011 to 75.1% in 2017 ( P < 0.001). Among unfavorable outcomes, the proportion of patients who failed, were lost to follow up, and were not evaluated had gradually decreased ( P < 0.001). In contrast, TB-related death rate was not significantly changed ( P = 0.513), while the non-TB related death rate had increased from 3.2% in 2011 to 11.1% in 2017 ( P < 0.001). Older age, male sex, immigrants, low household income, previous history of TB treatment, and comorbidities were independent predictors of unfavorable outcomes. Of the 5,308 patients who were successfully treated, recurrence occurred in 241 patients (4.5%) at a median 18.4 months (interquartile range, 9.2–32.4) after completion treatment. Conclusion The treatment outcomes of patients with MDR/RR-TB has gradually improved but increasing deaths during treatment is an emerging challenge for MDR-TB control in Korea. Targeted and comprehensive care is needed for vulnerable patients such as the elderly, patients with comorbidities, and those with low household incomes.

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Section: Discussionmentioning

confidence: 48%

Nationwide Treatment Outcomes of Patients With Multidrug/Rifampin-Resistant Tuberculosis in Korea, 2011–2017: A Retrospective Cohort Study (Korean TB-POST)

et al. 2023

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“…However, there are data to suggest that it may provide additional activity, in combination with other effective medications. The INH HD is included in the WHO-approved, short-course regimens, based on favorable outcomes in observational studies and randomized trials [ 1 , 4 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Time to Culture Conversion of Bedaquiline and High-Dose Isoniazid for Drug-Resistant Tuberculosis

Walsh

Vilbrun

Souroutzidis

et al. 2022

Open Forum Infectious Diseases

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“…Following the replacement of aminoglycosides by BDQ in longer regimens, the South African national TB programme elected in 2017 to allow the same substitution of agents within an “all-oral” shorter 9–12 month regimen under programmatic conditions. The long-term results of this observational cohort have recently been reported ([14 ▪ ]; Table 2). 688 participants were treated with BDQ containing regimens, whereas 699 were treated instead with an injectable agent.…”

Section: All-oral Multidrug Resistant Tuberculosis Treatment Regimens...mentioning

confidence: 91%

Update on drug treatments for multidrug resistant tuberculosis

Davies

Aston

2023

Current Opinion in Infectious Diseases

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Purpose of reviewTo describe important recent developments in the treatment of multidrug resistant tuberculosis (MDR-TB) Recent findingsIn the last decade, novel and repurposed antituberculosis drugs have transformed MDR-TB treatment with improved rates of treatment success, better tolerability and safety and reduced duration. As recently as 2016, standard care relied on up to seven drugs for 24 months with treatment success no better than 70%. Seven drug shorter so-called ''Bangladesh'' style regimens subsequently achieved similar or better results at a duration of 9--12 months but concerns about first-line resistance additional to rifampicin hampered global uptake. After conditional approval in 2012, the novel agent bedaquiline was demonstrated to improve outcomes and reduce mortality when used in longer and shorter regimens, resulting in the replacement of injectable agents. In the last 2 years, clinical trials of all-oral 6-month three or four drug regimens containing bedaquiline, pretomanid and linezolid have shown superior efficacy against both longer and shorter traditional regimens, resulting in major changes in WHO guidance.

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Treatment outcomes 24 months after initiating short, all-oral bedaquiline-containing or injectable-containing rifampicin-resistant tuberculosis treatment regimens in South Africa: a retrospective cohort study

Cited by 31 publications

References 22 publications

Nationwide Treatment Outcomes of Patients With Multidrug/Rifampin-Resistant Tuberculosis in Korea, 2011–2017: A Retrospective Cohort Study (Korean TB-POST)

Nationwide Treatment Outcomes of Patients With Multidrug/Rifampin-Resistant Tuberculosis in Korea, 2011–2017: A Retrospective Cohort Study (Korean TB-POST)

Time to Culture Conversion of Bedaquiline and High-Dose Isoniazid for Drug-Resistant Tuberculosis

Update on drug treatments for multidrug resistant tuberculosis

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