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Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis

Nasiri, Mohammad Javad, Zangiabadian, Moein, Arabpour, Erfan, Amini, Sirus, Khalili, Farima, Centis, Rosella, D'Ambrosio, Lia, Denholm, Justin T., Schaaf, H. Simon, van den Boom, Martin, Kurhasani, Xhevat, Dalcolmo, Margareth Pretti, Al-Abri, Seif, Muhwa, Jeremiah, Alffenaar, Jan-Willem, Akkerman, Onno, Silva, Denise Rossato, Torrico, Marcela Muňoz, Seaworth, Barbara, Pontali, Emanuele, Saderi, Laura, Tiberi, Simon, Zumla, Alimuddin, Migliori, Giovanni Battista and Sotgiu, Giovanni (2022) 'Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis'. International Journal of Infectious Diseases. (In Press)

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Abstract

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.

Item Type: Article
Subjects: QW Microbiology and Immunology > QW 45 Microbial drug resistance. General or not elsewhere classified.
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 360 Drug therapy
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1016/j.ijid.2022.02.043
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 21 Jul 2022 09:39
Last Modified: 06 Sep 2022 13:44
URI: https://archive.lstmed.ac.uk/id/eprint/20057

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