Effectiveness and safety of regimen containing bedaquiline and delamanid in patients with drug-resistant tuberculosis

Author:

Putra Oki Nugraha12,Yulistiani Yulistiani3,Soedarsono Soedarsono45,Subay Susi5

Affiliation:

1. Doctoral Program of Pharmacy, Faculty of Pharmacy, Airlangga University, Surabaya, Indonesia

2. Study Program of Pharmacy, Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia

3. Faculty of Pharmacy, Airlangga University, Surabaya, Indonesia

4. Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia

5. Department of Pulmonology and Respiratory Medicine, Dr. Soetomo Hospital, Surabaya, Indonesia

Abstract

Abstract Background: Bedaquiline and delamanid have been included in the individualized treatment regimen (ITR) to treat patients with drug-resistant tuberculosis (DR-TB). Objective: The objective of this study is to compare the effectiveness of sputum culture conversion and the safety of ITR containing bedaquiline and delamanid. Methods: Data were collected retrospectively from medical records of DR-TB patients who received ITR between January 2020 and December 2021. Patients were divided into bedaquiline and bedaquiline-delamanid groups. Sputum culture was evaluated until 6 months of treatment. Measurement of QTc interval, renal and liver function test, and serum potassium were evaluated to assess safety during the study period. We used Chi-square to analyze a difference in cumulative culture conversion; meanwhile, Wilcoxon and Mann–Whitney tests were used to analyze differences in laboratory data for each and between the two groups, respectively. Results: Fifty-one eligible DR-TB patients met the inclusion criteria, 41 in the bedaquiline and 10 in bedaquiline-delamanid group. 43/51 patients had a positive culture at baseline. After 6 months of treatment, 42/43 DR-TB patients (97.6%) had sputum culture conversion and no difference between the two groups (P ≥ 0.05). QTc interval within normal limit and no patient had a QTc >500 ms during the study period. Creatinine levels significantly differed between the two groups 6 months after treatment (P < 0.05). Conclusion: DR-TB patients who received all oral ITR containing bedaquiline and or delamanid demonstrated favorable sputum conversion with a tolerable safety profile.

Publisher

Medknow

Reference18 articles.

1. Delamanid-containing regimens and multidrug-resistant tuberculosis:A systematic review and meta-analysis;Nasiri;Int J Infect Dis,2022

2. The activities and secretion of cytokines caused by delamanid on macrophages infected by multidrug-resistant Mycobacterium tuberculosis strains;Lyu;Front Immunol,2021

3. Bedaquiline correlation to QT interval prolongation in DR-TB patients;Primadana;J Resp,2022

4. Bedaquiline effect on QT interval of drugs-resistant tuberculosis patients:Real world data;Darmayani;Acta Med Indones,2022

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