TY - JOUR
T1 - Delamanid-containing regimens and multidrug-resistant tuberculosis
T2 - A systematic review and meta-analysis
AU - Nasiri, Mohammad Javad
AU - Zangiabadian, Moein
AU - Arabpour, Erfan
AU - Amini, Sirus
AU - Khalili, Farima
AU - Centis, Rosella
AU - D'Ambrosio, Lia
AU - Denholm, Justin T
AU - Schaaf, H Simon
AU - van den Boom, Martin
AU - Kurhasani, Xhevat
AU - Dalcolmo, Margareth Pretti
AU - Al-Abri, Seif
AU - Chakaya, Jeremiah
AU - Alffenaar, Jan-Willem
AU - Akkerman, Onno
AU - Silva, Denise Rossato
AU - Muňoz-Torrico, Marcela
AU - Seaworth, Barbara
AU - Pontali, Emanuele
AU - Saderi, Laura
AU - Tiberi, Simon
AU - Zumla, Alimuddin
AU - Migliori, Giovanni Battista
AU - Sotgiu, Giovanni
N1 - Copyright © 2022. Published by Elsevier Ltd.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - INTRODUCTION: Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis is available to comprehensively evaluate the role of delamanid (DLM), we evaluated its effectiveness and safety.METHODS: We reviewed the relevant scientific literature published up to January 20, 2022. The pooled success treatment rate with 95% confidence intervals (CI) was assessed using a random-effect model. We assessed studies for quality and bias, and considered P<0.05 to be statistically significant.RESULTS: After reviewing 626 records, we identified 25 studies that met the inclusion criteria, 22 observational and 3 experimental, with 1276 and 411 patients, respectively. In observational studies the overall pooled treatment success rate of DLM-containing regimens was 80.9% (95% CI 72.6-87.2) with no evidence of publication bias (Begg's test; P >0.05). The overall pooled treatment success rate in DLM and bedaquiline-containing regimens was 75.2% (95% CI 68.1-81.1) with no evidence of publication bias (Begg's test; P >0.05). In experimental studies the pooled treatment success rate of DLM-containing regimens was 72.5 (95% CI 44.2-89.8, P <0.001, I2: 95.1%) with no evidence of publication bias (Begg's test; P >0.05).CONCLUSIONS: In MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events.
AB - INTRODUCTION: Multidrug-resistant tuberculosis (MDR-TB) is a life-threatening condition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis is available to comprehensively evaluate the role of delamanid (DLM), we evaluated its effectiveness and safety.METHODS: We reviewed the relevant scientific literature published up to January 20, 2022. The pooled success treatment rate with 95% confidence intervals (CI) was assessed using a random-effect model. We assessed studies for quality and bias, and considered P<0.05 to be statistically significant.RESULTS: After reviewing 626 records, we identified 25 studies that met the inclusion criteria, 22 observational and 3 experimental, with 1276 and 411 patients, respectively. In observational studies the overall pooled treatment success rate of DLM-containing regimens was 80.9% (95% CI 72.6-87.2) with no evidence of publication bias (Begg's test; P >0.05). The overall pooled treatment success rate in DLM and bedaquiline-containing regimens was 75.2% (95% CI 68.1-81.1) with no evidence of publication bias (Begg's test; P >0.05). In experimental studies the pooled treatment success rate of DLM-containing regimens was 72.5 (95% CI 44.2-89.8, P <0.001, I2: 95.1%) with no evidence of publication bias (Begg's test; P >0.05).CONCLUSIONS: In MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events.
U2 - 10.1016/j.ijid.2022.02.043
DO - 10.1016/j.ijid.2022.02.043
M3 - Article
C2 - 35245659
SN - 1201-9712
VL - 124
SP - S90-S103
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -