含贝达喹啉的治疗方案对耐药结核病患者的疗效和安全性:最新系统综述和荟萃分析

IF 1.9 Q3 INFECTIOUS DISEASES
Obaid Ur Rehman , Eeshal Fatima , Abraish Ali , Umar Akram , Abdulqadir Nashwan , Faryal Yunus
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引用次数: 0

摘要

背景结核病是由结核分枝杆菌引起的一种传染病,如果不及时治疗会导致严重的并发症。结核分枝杆菌的某些菌株对多种药物具有抗药性,需要使用较新的药物进行治疗。以贝达喹啉为基础的治疗方案已被用于确诊为耐药结核病的患者。本研究旨在通过对现有文献进行系统回顾和荟萃分析,评估贝达喹啉治疗方案的疗效和安全性。采用随机效应模型评估汇总治疗成功率和 95 % CIs。本综述已在 PROSPERO 注册:CRD42023432748.Results通过数据库搜索共检索到 543 篇文章,其中有 12 项新研究符合纳入标准。纳入综述的文章总数为 41 篇,包括 36 项观察性研究(共有 9,934 名患者)和 5 项实验性研究(共有 468 名患者)。观察性研究的治疗成功率为 76.9%(95% CI,72.9-80.4),实验性研究的治疗成功率为 81.7%(95% CI,67.2-90.7)。根据仅含有贝达喹啉的治疗方案和含有贝达喹啉和地拉那米的治疗方案,进一步进行了分组分析。在只使用含有贝达喹啉的治疗方案的研究中,汇总的治疗成功率为78.4%(95% CI,74.2-82.1),而在使用含有贝达喹啉和地拉马尼的治疗方案的研究中,汇总的治疗成功率为73.6%(95% CI,64.6-81.0)。结论在使用贝达喹啉治疗方案的耐药结核病患者中,具有高度耐药结核分枝杆菌菌株的患者的培养转换率和治疗成功率都很高。此外,贝达喹啉疗法的安全性在所有研究中都得到了证实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy and safety of bedaquiline containing regimens in patients of drug-resistant tuberculosis: An updated systematic review and meta-analysis

Background

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and leads to serious complications if left untreated. Some strains of Mycobacterium tuberculosis are multi-drug resistant and require treatment with newer drugs. Bedaquiline based treatment regimens have been used in patients who are diagnosed with drug resistant tuberculosis. The aim of this study is to assess the efficacy and safety profile of bedaquiline-based treatment regimens using a systematic review of existing literature and meta-analysis.

Methods

In this study, an electronic search was carried out on PubMed, ScienceDirect, and Cochrane library to find relevant literature from March 2021 onwards. Random-effects model was used to assess pooled treatment success rate and 95 % CIs. p-value of <0.05 was suggestive of publication bias. The review is registered with PROSPERO: CRD42023432748.

Results

A total of 543 articles were retrieved by database searching, out of which 12 new studies met the inclusion criteria. The total number of articles included in the review was 41 including 36 observational studies (having a total of 9,934 patients) and 5 experimental studies (having a total of 468 patients). The pooled treatment success rate was 76.9 % (95 % CI, 72.9–80.4) in the observational studies and 81.7 % (95 % CI, 67.2–90.7) in the experimental studies. Further subgroup analysis was done on the basis of treatment regimens containing bedaquiline only and treatment regimens containing bedaquiline and delamanid. The pooled treatment success rate in the studies consisting of patients who were treated with regimens containing bedaquiline only was 78.4 % (95 % CI, 74.2–82.1) and 73.6 % (95 % CI, 64.6–81.0) in studies consisting of patients who were treated with regimens containing bedaquiline and delamanid. There was no evidence of publication bias.

Conclusions

In patients of drug resistant tuberculosis having highly resistant strains of Mycobacterium tuberculosis undergoing treatment with bedaquiline-based regimen demonstrate high rates of culture conversion and treatment success. Moreover, the safety profile of bedaquiline-based regimens is well-established in all studies.

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来源期刊
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.00
自引率
5.00%
发文量
44
审稿时长
30 weeks
期刊介绍: Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.
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