Affiliation:
1. Almazov National Medical Research Center,
Russian Ministry of Health
2. St. Petersburg Research Institute of Phthisiopulmonology,
Russian Ministry of Health
3. St. Petersburg Department of Steklov Mathematical Institute of Russian Academy of Sciences; St. Petersburg University
4. I. M. Sechenov First Moscow State Medical University, Russian Ministry of Health; Immunology Research Institute by the Russian Federal Medical Biological Agency
Abstract
The objective: to determine the rate of treatment success in MDR and XDR pulmonary tuberculosis patients when treated with chemotherapy regimens containing bedaquiline based on a meta-analysis using mathematical modeling.Subjects and Methods. We searched and analyzed published studies of bedaquiline conducted from 2014 to 2022 in the Russian Federation. A total of 41 publications were found, of which 15 were included in the meta-analysis since they contained data eligible for analysis. They presented treatment results of 1,356 TB patients, 886 (65,3%) patients had MDR TB, and 470 (34,7%) had XDR TB (according to the definition as of 2020). All of them received bedaquiline within the standard regimen for 24–26 weeks.Results. According to the meta-analysis results, when using treatment regimens containing bedaquiline in MDR/XDR TB patients, sputum conversion was achieved in 79,6% (95% CI 75,1–83,4) of cases, and effective treatment was observed in 82,0% (95% CI 78,6–84.9) of cases. Treatment default was noted in 8,7% (95% CI 5,7–13,1) of cases. At the same time, there is a statistically significant relationship (p<0,01) between the proportion of patients with comorbidities and the proportion of patients with incomplete treatment. Lethal outcomes were recorded in 5,8% (95% CI 3,6–9,2), which were associated with the severe course of tuberculosis and concomitant pathology. Bedaquiline was canceled in 7,8% (95% CI 4,0–13,5) of cases. When analyzing the data of patients with MDR TB and XDR TB separately, treatment efficacy differed and amounted to 89,9% (95% CI 85,9–92,9) versus 71,9% (95% CI 66,3–76,8), respectively.
Publisher
LLC "Medical Knowledge and Technologies"
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