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

Nasiri, MJ; Zangiabadian, M; Arabpour, E; Amini, S; Khalili, F; Centis, R; D'Ambrosio, L; ... Sotgiu, G; + view all (2022) Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis. International Journal of Infectious Diseases 10.1016/j.ijid.2022.02.043. (In press). Green open access

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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.

Type: Article
Title: Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis
Location: Canada
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ijid.2022.02.043
Publisher version: https://doi.org/10.1016/j.ijid.2022.02.043
Language: English
Additional information: This is an open access article under the CC BY-NC-ND IGO license (http://creativecommons.org/licenses/by-nc-nd/3.0/igo/).
Keywords: MDR-TB, TB, bedaquiline, delamanid, effectiveness, safety
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10146093
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