Interim treatment outcomes in multidrug-resistant tuberculosis patients treated sequentially with bedaquiline and delamanid.

Interim treatment outcomes in multidrug-resistant tuberculosis patients treated sequentially with bedaquiline and delamanid.

Int J Infect Dis. 2020 Jul 05;:

Authors: Lee HH, Jo KW, Yim JJ, Jeon D, Kang H, Shim TS

Abstract
OBJECTIVES: The objective of this study was to evaluate the efficacy and safety of sequential use of bedaquiline (Bdq) and delamanid (Dlm) in multidrug-resistant tuberculosis (MDR-TB) patients with limited treatment options.
METHODS: This study evaluated 74 MDR-TB patients treated with Bdq, followed by Dlm (n = 22), or vice versa (n = 52), combined with optimised background regimens between March 2016 and December 2018.
RESULTS: The mean age of the participants was 49.0 ± 15.8 years. Fifty-one (68.9%) of the participants were men. Fluoroquinolone-resistance was identified in 54 (72.9%) patients, including 20 (27.0%) with extensively drug-resistant TB. Of the 47 (63.5%) patients with positive cultures at the commencement of the first new drug, culture conversion occurred in 44 (93.6%). The interim treatment outcome after 12 months was favourable in 68/74 patients (91.9%). Of 148 episodes of new drug use, 137 (92.3%) completed 24 weeks of treatment. Of the 11 early discontinuation events, six patients stopped using a new drug due to adverse drug reactions that were not life-threatening, including one (1.4%) who stopped Bdq due to QT-prolongation.
CONCLUSIONS: Sequential use of the two new drugs appears to be an effective and safe option for MDR-TB patients with few treatment options.

PMID: 32640367 [PubMed - as supplied by publisher]