TY - JOUR T1 - Outcomes for multidrug-resistant tuberculosis patients with and without resistance to fluoroquinolones and second-line injectable drugs: A meta-analysis of individual patient data JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - 4286 AU - G.B. Migliori AU - S. Ahuja AU - D. Ashkin AU - M. Avendano AU - R. Banerjee AU - M. Bauer AU - J. Bayona AU - M. Becerra AU - A. Benedetti AU - M. Burgos AU - R. Centis AU - E.D. Chan AU - C.-Y. Chiang AU - H. Cox AU - L. D'Ambrosio AU - K. DeRiemer AU - N.H. Dung AU - D. Enarson AU - K. Flanagan AU - J. Flood AU - M.L. Garcia-Garcia AU - N. Gandhi AU - R. Granich AU - M.G. Hollm-Delgado AU - T.H. Holtz AU - M. Iseman AU - L. Jarlsberg AU - S. Keshavjee AU - H.R. Kim AU - W.-J. Koh AU - J. Lancaster AU - C. Lange AU - W.C.M. de Lange AU - V. Leimane AU - C.C. Leung AU - J. Li AU - S. Mishustin AU - C. Mitnick AU - M. Narita AU - P. O'Riordan AU - M. Pai AU - D. Palmero AU - S.K. Park AU - G. Pasvol AU - J. Pena AU - C. Pérez-Guzmán AU - M. Quelapio AU - A. Ponce-de-Leon AU - V. Riekstina AU - J. Robert AU - S. Royce AU - H.S. Schaaf AU - K.J. Seung AU - L. Shah AU - T.S. Shim AU - S.S. Shin AU - Y. Shiraishi AU - J. Sifuentes-Osornio AU - G. Sotgiu AU - M.J. Strand AU - P. Tabarsi AU - T.E. Tupasi AU - R. van Altena AU - M. Van der Walt AU - T.S. Van der Werf AU - M.H. Vargas AU - P. Viiklepp AU - J. Westenhouse AU - W.W. Yew AU - J.J. Yim AU - D. Menzies Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/4286.abstract N2 - Poor treatment outcomes have been reported for tuberculosis (TB) patients harbouring strains resistant to isoniazid and rifampicin (multidrug resistance or MDR-TB), fluoroquinolones and/or second-line injectable drugs.We undertook a meta-analysis for response to treatment using individual data for MDR-TB patients whose strains had additional resistance to fluoroquinolones (MDR-TB+FQ), second-line injectables (MDR-TB+Inj) or both (extensive drug resistance; XDR-TB) including demographic and clinical details, treatment regimens, and outcomes.26 centres provided data for 424 MDR-TB+FQ, 1129 MDR-TB+Inj, 405 XDR-TB, and 4776 other MDR-TB patients susceptible to FQ and Inj. Success was lower in MDR-TB+FQ (adjusted OR=0.6 [95%CL 0.5-0.7]) and XDR-TB patients (0.4 [0.3-0.6]) than in those with MDR-TB+Inj (0.8 [0.7-0.9]) and those with MDR-TB and no additional resistance (reference). No single drug was significantly associated with treatment success in MDR-TB+FQ and XDR-TB patients. In XDR-TB patients, success was highest if at least 6 drugs were used in the intensive phase (4.9 [1.4-16.6]) and 4 in the continuation phase (6.1[1.4-26.3]).Study results suggest that regimens of a similar duration to those recommended in MDR-TB patients but containing more drugs achieve better results in XDR-TB patients. As all data in the analysis were from observational studies, bias may be substantial and better quality evidence will be needed to guide the optimization of regimens. ER -