Abstract
Evaluation of novel anti-tuberculosis (TB) medicines 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 country of MDR-TB.
Method We systematically analysed the “SIMETB” national electronic TB database in the Republic of Moldova 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 WHO and TBNET definitions (55.3% versus 24.6%, p=0.001 and 43.5% versus 19.6% p=0.004, correspondingly), as well, a lower mortality rate (8.8% versus 20.2%, p<0.001, by WHO and 10.9% versus 25.2%, p=0.01, by TBNET). In patients who previously failed on MDR-TB treatment, more than 40% of patients achieved cure with a bedaquiline-containing regimen.
Conclusions Bedaquiline-based MDR-TB treatment regimens result in better disease resolution when compared to bedaquiline-sparing MDR-TB treatment regimens under programmatic conditions in a country with a high-burden of MDR-TB.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. D. Chesov has nothing to disclose.
Conflict of interest: Dr. Heyckendorf reports personal fees from Chiesi, from Gilead, from Janssen, from Lucane, outside the submitted work.
Conflict of interest: Dr. Alexandru has nothing to disclose.
Conflict of interest: Dr. Donica has nothing to disclose.
Conflict of interest: Dr. E. Chesov Chesov has nothing to disclose.
Conflict of interest: Dr. Reiman has nothing to disclose.
Conflict of interest: Dr. Crudu has nothing to disclose.
Conflict of interest: Dr. Botnaru has nothing to disclose.
Conflict of interest: Dr. Lange reports personal fees from Chiesi, personal fees from Gilead, personal fees from Janssen, personal fees from Lucane, personal fees from Novartis, personal fees from Oxoid, personal fees from Berlin Chemie, personal fees from Thermofisher, personal fees from Oxfordimmunotec, outside the submitted work.
- Received July 1, 2020.
- Accepted November 23, 2020.
- Copyright ©ERS 2020
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