含预马尼肽疗法对耐药结核病的疗效:临床试验的系统回顾和荟萃分析。

Narra J Pub Date : 2023-12-01 Epub Date: 2023-11-13 DOI:10.52225/narra.v3i3.402
Arya M Simanjuntak, Raehan Daenansya, Putri M Aflandhanti, Indra Yovi, Suyanto Suyanto, Dewi Anggraini, Dani Rosdiana
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引用次数: 0

摘要

世界卫生组织(WHO)对耐药性结核病(DR-TB)感染的增加以及对治疗时间更短、副作用更小的新药的需求表示担忧。世卫组织修订了其指南,规定在 2022 年使用 BPaLM(贝达喹啉、丙托马尼、利奈唑胺和莫西沙星)治疗耐多药结核病(MDR-TB),疗程为 6 个月。然而,由于证实含丙托马尼治疗方案有效性的证据可信度有限,因此需要对现有证据进行全面研究和荟萃分析。本系统综述和荟萃分析的目的是评估含有前马尼肽的方案治疗 DR-TB 患者的有效性。根据 PICOS 框架,采用纳入标准对六个搜索引擎中的数据进行了搜索。使用的关键词为前马尼肽和结核病或其替代物。使用 RoB2 Cochrane 随机临床试验偏倚风险工具,独立提取数据并评估数据质量。使用了比值比(OR)和异质性检验,研究结果以比值比和森林图的形式呈现。共有四项研究的 237 名患者被纳入最终分析,其中 204 名患者(86%)的治疗结果良好(治愈),33 名患者(14%)未治愈。含有前马尼肽的方案(OR:46.73;95%CI:11.76-185.7)和 BPaLM/BPaL 方案(OR:41.67;95%CI:8.86-196.73)与预后良好(治愈)相关。这项荟萃分析表明,含有前马尼肽的方案和 BPaLM/BPaL 方案可增加 DR-TB 患者获得良好疗效的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of pretomanid-containing regiments for drug-resistant tuberculosis: A systematic review and meta-analysis of clinical trials.

Concerns regarding the rise of drug-resistant tuberculosis (DR-TB) infections and the need for new drugs with shorter treatment time and fewer side effects have been voiced by the World Health Organization (WHO). The WHO revised its guideline to treat multidrug resistant tuberculosis (MDR-TB) with a 6-month course of BPaLM (bedaquiline, pretomanid, linezolid and moxifloxacin) in 2022. However, a thorough study and meta-analysis of available evidence is required due to the limited confidence of the evidence confirming the effectiveness of pretomanid-containing regiments. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of pretomanid-containing regiments in treating DR-TB patients. Data from six search engines were searched using inclusion criteria based on the PICOS framework. The keywords of pretomanid and tuberculosis or their alternatives were used. Using RoB2 Cochrane risk-of-bias tool for randomized clinical trials, data were independently extracted and the quality of the data was evaluated. Odds ratio (OR) and heterogeneity tests were used and the findings were presented in ORs and forest plots. A total of four studies with 237 patients was included in the final analysis and 204 (86%) patients had favorable outcome (cured) and 33 (14%) was not cured. Pretomanid-containing regimen (OR: 46.73; 95%CI: 11.76-185.7) and BPaLM/BPaL (OR: 41.67; 95%CI: 8.86-196.73) regimens were associated with favorable outcome (cured). This meta-analysis indicates that the pretomanid-containing regimen and the BPaLM/BPaL regimen could increase the chance to have favorable outcome in DR-TB patients.

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