TY - JOUR T1 - Long-term outcome and safety of prolonged bedaquiline treatment for multidrug-resistant tuberculosis JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01799-2016 SP - 1601799 AU - Lorenzo Guglielmetti AU - Marie Jaspard AU - Damien Le Dû AU - Marie Lachâtre AU - Dhiba Marigot-Outtandy AU - Christine Bernard AU - Nicolas Veziris AU - Jérôme Robert AU - Yazdan Yazdanpanah AU - Eric Caumes AU - Mathilde Fréchet-Jachym Y1 - 2016/12/15 UR - http://erj.ersjournals.com/content/early/2016/12/22/13993003.01799-2016.abstract N2 - Bedaquiline, a recently approved drug for the treatment of multidrug-resistant tuberculosis (MDR-TB), is recommended for a duration of 24 weeks. There are scarce data on patients treated with this drug outside clinical trials.All MDR-TB patients who started treatment from January 1, 2011 to December 31, 2013 and received ≥30 days of bedaquiline were included in a multicentre observational cohort.Among 45 MDR-TB patients, 53% harboured isolates resistant to both fluoroquinolones and second-line injectables, and 38% harboured isolates resistant to one of these drug classes. Median bedaquiline treatment duration was 361 days and 33 patients (73%) received prolonged (>190 days) bedaquiline treatment. Overall, 36 patients (80%) had favourable outcome, five were lost to follow-up, three died, and one failed and acquired bedaquiline resistance. No cases of recurrence were reported. Severe and serious adverse events were recorded in 60% and 18% of patients, respectively. Values of Fridericia-corrected QT interval (QTcF) >500 ms were recorded in 11% of patients, but neither arrhythmias nor symptomatic cardiac side-effects occurred. Bedaquiline was discontinued in three patients following QTcF prolongation. No significant differences in outcomes or adverse events rates were observed between patients receiving standard and prolonged bedaquiline treatment.Bedaquiline-containing regimens achieved favourable outcomes in a large proportion of patients. Prolonged bedaquiline treatment was overall well tolerated in this cohort.Treatment regimens including prolonged bedaquiline use are effective and overall well tolerated in MDR-TB patients http://ow.ly/vhtl305CYJj ER -