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Outcomes of Bedaquiline Treatment in Patients with Multidrug-Resistant Tuberculosis

2019; Centers for Disease Control and Prevention; Volume: 25; Issue: 5 Linguagem: Inglês

10.3201/eid2505.181823

1080-6059

Lawrence Mbuagbaw, Lorenzo Guglielmetti, Catherine Hewison, Nyasha Bakare, Mathieu Bastard, Éric Caumes, Mathilde Fréchet-Jachym, J. Robert, Nicolas Véziris, Naira Khachatryan, Tinatin Kotrikadze, Արմեն Հայրապետյան, Zaza Avaliani, Holger J. Schünemann, Christian Lienhardt,

Epilepsy research and treatment

Abstract Bedaquiline is recommended by the World Health Organization for the treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB). We pooled data from 5 cohorts of patients treated with bedaquiline in France, Georgia, Armenia, and South Africa and in a multicountry study. The rate of culture conversion to negative at 6 months (by the end of 6 months of treatment) was 78% (95% CI 73.5%–81.9%), and the treatment success rate was 65.8% (95% CI 59.9%–71.3%). Death rate was 11.7% (95% CI 7.0%–19.1%). Up to 91.1% (95% CI 82.2%–95.8%) of the patients experienced >1 adverse event, and 11.2% (95% CI 5.0%–23.2%) experienced a serious adverse event. Lung cavitations were consistently associated with unfavorable outcomes. The use of bedaquiline in MDR and XDR TB treatment regimens appears to be effective and safe across different settings, although the certainty of evidence was assessed as very low.