Abstract
Background Evaluation of novel anti-tuberculosis (TB) drugs for the treatment of multidrug-resistant (MDR)-TB continues to be of high interest on the TB research agenda. We assessed treatment outcomes in patients with pulmonary MDR-TB who received bedaquiline-containing treatment regimens in the Republic of Moldova, a high-burden MDR-TB country.
Method We systematically analysed the SIMETB national electronic TB database and performed a retrospective propensity score-matched comparison of treatment outcomes in a cohort of patients with MDR-TB who started treatment during 2016–2018 with a bedaquiline-containing regimen (bedaquiline cohort) and a cohort of patients treated without bedaquiline (non-bedaquiline cohort).
Results Following propensity score matching, 114 patients were assigned to each cohort of MDR-TB patients. Patients in the bedaquiline cohort had a higher 6-month sputum culture conversion rate than those in the non-bedaquiline cohort (66.7% versus 40.3%; p<0.001). Patients under bedaquiline-containing regimens had a higher cure rate assessed by both World Health Organization (WHO) and TBnet definitions (55.3% versus 24.6%; p=0.001 and 43.5% versus 19.6%; p=0.004, respectively), as well as a lower mortality rate (8.8% versus 20.2%; p<0.001 and 10.9% versus 25.2%; p=0.01, respectively). In patients who previously failed on MDR-TB treatment, >40% of patients achieved a cure with a bedaquiline-containing regimen.
Conclusions Bedaquiline-based MDR-TB treatment regimens result in better disease resolution when compared with bedaquiline-sparing MDR-TB treatment regimens under programmatic conditions in a country with a high burden of MDR-TB.
Abstract
Used under programmatic conditions in a high-burden MDR-TB setting, bedaquiline-based MDR-TB treatment regimens result in faster and more sustained disease resolution than bedaquiline-sparing MDR-TB treatment regimens https://bit.ly/37mSQOT
Footnotes
This article has an editorial commentary: https://doi.org/10.1183/13993003.00066-2021
Conflict of interest: D. Chesov has nothing to disclose.
Conflict of interest: J. Heyckendorf reports personal fees for lectures from Chiesi, Gilead, Janssen and Lucane, outside the submitted work.
Conflict of interest: S. Alexandru has nothing to disclose.
Conflict of interest: A. Donica has nothing to disclose.
Conflict of interest: E. Chesov has nothing to disclose.
Conflict of interest: M. Reimann has nothing to disclose.
Conflict of interest: V. Crudu has nothing to disclose.
Conflict of interest: V. Botnaru has nothing to disclose.
Conflict of interest: C. Lange reports personal fees for lectures from Chiesi, Gilead, Janssen, Lucane, Novartis, Oxoid, Berlin-Chemie and Thermo Fisher, personal fees for meeting attendance from Oxford Immunotec, outside the submitted work.
- Received July 1, 2020.
- Accepted November 23, 2020.
- Copyright ©ERS 2021