Efficacy and safety of shorter multidrug-resistant or rifampicin-resistant tuberculosis regimens: a network meta-analysis.

Publication date: Oct 01, 2024

Drug-resistant tuberculosis (DR-TB) remains a threat to public health. Shorter regimens have been proposed as potentially valuable treatments for multidrug or rifampicin resistant tuberculosis (MDR/RR-TB). We undertook a systematic review and network meta-analysis to evaluate the efficacy and safety of shorter MDR/RR-TB regimens. We searched PubMed/MEDLINE, Cochrane Center for Clinical Trials (CENTRAL), Scopus, ClinicalTrials. gov, WHO International Clinical Trials Registry Platform, US Food and Drug Administration, and Chinese Clinical Trial Registry for primary articles published from 2013 to July 2023. Favorable (cured and treatment completed) and unfavorable (treatment failure, death, loss to follow-up, and culture conversion) outcomes were assessed as the main efficacy outcomes, while adverse events were assessed as the safety outcomes. The network meta-analysis was performed using R Studio version 4. 3.1 and the Netmeta package. The study protocol adhered to the PRISMA-NMA guidelines and was registered in PROSPERO (CRD42023434050). We included 11 eligible studies (4 randomized control trials and 7 cohorts) that enrolled 3,548 patients with MDR/RR-TB. Treatment with a 6-month combination of BdqLzdLfxZTrd/Eto/H had two times more favorable outcomes [RR 2. 2 (95% CI 1. 22, 4. 13), P = 0. 0094], followed by a 9-11 month combination of km/CmMfx/LfxPtoCfzZEHh [RR1. 67 (95% CI 1. 45, 1. 92), P 

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Concepts Keywords
Clinicaltrials Antitubercular Agents
Crd42023434050 Antitubercular Agents
July Humans
Tuberculosis Multidrug-resistant tuberculosis (MDR-TB)
Valuable Mycobacterium tuberculosis
Network Meta-Analysis
Network meta-analysis
Rifampicin-resistant tuberculosis (RR-TB)
Rifampin
Rifampin
Short- term regimens
Systematic review
Treatment Outcome
Tuberculosis, Multidrug-Resistant

Semantics

Type Source Name
drug DRUGBANK Rifampicin
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease MESH Drug-resistant tuberculosis
disease MESH treatment failure
disease MESH death
disease MESH Infectious Diseases
pathway REACTOME Reproduction
drug DRUGBANK Coenzyme M
drug DRUGBANK Spinosad
drug DRUGBANK Bedaquiline
drug DRUGBANK Pretomanid
drug DRUGBANK Linezolid
drug DRUGBANK Moxifloxacin
drug DRUGBANK Trestolone
drug DRUGBANK Levofloxacin
drug DRUGBANK Pyrazinamide
drug DRUGBANK Ethionamide
drug DRUGBANK Isoniazid
disease MESH drug toxicity
drug DRUGBANK Delamanid
drug DRUGBANK Clofazimine
disease IDO intervention
drug DRUGBANK Capreomycin
drug DRUGBANK Cycloserine
drug DRUGBANK Kanamycin
drug DRUGBANK Protionamide
drug DRUGBANK Terizidone
drug DRUGBANK Ethambutol
drug DRUGBANK Meropenem
drug DRUGBANK Amikacin
drug DRUGBANK Streptomycin
disease MESH Allergy
disease MESH AIDS
drug DRUGBANK Tretamine
disease MESH birth defect
drug DRUGBANK Gatifloxacin
disease IDO drug susceptibility
disease IDO history
disease MESH HIV infection
pathway REACTOME HIV Infection
disease MESH diabetes mellitus
disease MESH hypokalemia
disease MESH anemia
pathway REACTOME Cardiac conduction
disease MESH gastrointestinal disorder
disease MESH Peripheral neuropathy
disease MESH hepatitis B
pathway KEGG Hepatitis B
disease MESH acute liver failure
disease MESH sepsis
disease MESH heart failure
disease MESH suicide
disease MESH peritonitis
disease MESH cryptococcal meningitis
disease IDO immunodeficiency
disease MESH pulmonary tuberculosis
disease IDO country
drug DRUGBANK Alteplase
drug DRUGBANK (S)-Des-Me-Ampa
disease MESH extensively drug resistant tuberculosis

Original Article

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