TY - JOUR
T1 - Delamanid-containing regimens and multidrug-resistant tuberculosis: 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 - Muhwa, Chakaya
AU - Alffenaar, Jan-Willem
AU - Akkerman, Onno
AU - Silva, Denise Rossato
AU - Torrico, Marcela Muňoz
AU - Seaworth, Barbara
AU - Pontali, Emanuele
AU - Saderi, Laura
AU - Tiberi, Simon
AU - Zumla, Alimuddin
AU - Migliori, Giovanni Battista
AU - Sotgiu, Giovanni
PY - 2022/3/1
Y1 - 2022/3/1
N2 - IntroductionMultidrug-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.MethodsWe 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.ResultsAfter 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).ConclusionsIn MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events.
AB - IntroductionMultidrug-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.MethodsWe 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.ResultsAfter 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).ConclusionsIn MDR-TB patients receiving DLM, culture conversion and treatment success rates were high despite extensive resistance with limited adverse events.
KW - bedaquiline
KW - delamanid
KW - effectiveness
KW - MDR-TB
KW - safety
KW - TB
U2 - 10.1016/j.ijid.2022.02.043
DO - 10.1016/j.ijid.2022.02.043
M3 - Article
SN - 1201-9712
VL - 124
SP - S90-S103
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -
