Details

Autor(en) / Beteiligte

• Ahuja, Shama D
• Ashkin, David
• Avendano, Monika
• Banerjee, Rita
• Bauer, Melissa
• Bayona, Jamie N
• Becerra, Mercedes C
• Benedetti, Andrea
• Burgos, Marcos
• Centis, Rosella
• Chan, Eward D
• Chiang, Chen-Yuan
• Cox, Helen
• D'Ambrosio, Lia
• DeRiemer, Kathy
• Dung, Nguyen Huy
• Enarson, Donald
• Falzon, Dennis
• Flanagan, Katherine
• Flood, Jennifer
• Garcia-Garcia, Maria L
• Gandhi, Neel
• Granich, Reuben M
• Hollm-Delgado, Maria G
• Holtz, Timothy H
• Iseman, Michael D
• Jarlsberg, Leah G
• Keshavjee, Salmaan
• Kim, Hye-Ryoun
• Koh, Won-Jung
• Lancaster, Joey
• Lange, Christophe
• de Lange, Wiel C M
• Leimane, Vaira
• Leung, Chi Chiu
• Li, Jiehui
• Menzies, Dick
• Migliori, Giovanni B
• Mishustin, Sergey P
• Mitnick, Carole D
• Narita, Masa
• O'Riordan, Philly
• Pai, Madhukar
• Palmero, Domingo
• Park, Seung-kyu
• Pasvol, Geoffrey
• Peña, Jose
• Pérez-Guzmán, Carlos
• Quelapio, Maria I D
• Ponce-de-Leon, Alfredo
• Riekstina, Vija
• Robert, Jerome
• Royce, Sarah
• Schaaf, H Simon
• Seung, Kwonjune J
• Shah, Lena
• Shim, Tae Sun
• Shin, Sonya S
• Shiraishi, Yuji
• Sifuentes-Osornio, José
• Sotgiu, Giovanni
• Strand, Matthew J
• Tabarsi, Payam
• Tupasi, Thelma E
• van Altena, Robert
• Van der Walt, Martie
• Van der Werf, Tjip S
• Vargas, Mario H
• Viiklepp, Pirett
• Westenhouse, Janice
• Yew, Wing Wai
• Yim, Jae-Joon
• Evans, Carlton

Titel

Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients

Ist Teil von

• PLoS medicine, 2012-08, Vol.9 (8), p.e1001300

Ort / Verlag

United States: Public Library of Science

Erscheinungsjahr

2012

Quelle

MEDLINE

Beschreibungen/Notizen

• Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB. Three recent systematic reviews were used to identify studies reporting treatment outcomes of microbiologically confirmed MDR-TB. Study authors were contacted to solicit individual patient data including clinical characteristics, treatment given, and outcomes. Random effects multivariable logistic meta-regression was used to estimate adjusted odds of treatment success. Adequate treatment and outcome data were provided for 9,153 patients with MDR-TB from 32 observational studies. Treatment success, compared to failure/relapse, was associated with use of: later generation quinolones, (adjusted odds ratio [aOR]: 2.5 [95% CI 1.1-6.0]), ofloxacin (aOR: 2.5 [1.6-3.9]), ethionamide or prothionamide (aOR: 1.7 [1.3-2.3]), use of four or more likely effective drugs in the initial intensive phase (aOR: 2.3 [1.3-3.9]), and three or more likely effective drugs in the continuation phase (aOR: 2.7 [1.7-4.1]). Similar results were seen for the association of treatment success compared to failure/relapse or death: later generation quinolones, (aOR: 2.7 [1.7-4.3]), ofloxacin (aOR: 2.3 [1.3-3.8]), ethionamide or prothionamide (aOR: 1.7 [1.4-2.1]), use of four or more likely effective drugs in the initial intensive phase (aOR: 2.7 [1.9-3.9]), and three or more likely effective drugs in the continuation phase (aOR: 4.5 [3.4-6.0]). In this individual patient data meta-analysis of observational data, improved MDR-TB treatment success and survival were associated with use of certain fluoroquinolones, ethionamide, or prothionamide, and greater total number of effective drugs. However, randomized trials are urgently needed to optimize MDR-TB treatment. Please see later in the article for the Editors' Summary.