Dataset Information

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

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.

SUBMITTER: Nasiri MJ

PROVIDER: S-EPMC9731904 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

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

Nasiri Mohammad Javad MJ Zangiabadian Moein M Arabpour Erfan E Amini Sirus S Khalili Farima F Centis Rosella R D'Ambrosio Lia L Denholm Justin T JT Schaaf H Simon HS van den Boom Martin M Kurhasani Xhevat X Dalcolmo Margareth Pretti MP Al-Abri Seif S Chakaya Jeremiah J Alffenaar Jan-Willem JW Akkerman Onno O Silva Denise Rossato DR Muňoz-Torrico Marcela M Seaworth Barbara B Pontali Emanuele E Saderi Laura L Tiberi Simon S Zumla Alimuddin A Migliori Giovanni Battista GB Sotgiu Giovanni G

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 20220302

<h4>Introduction</h4>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.<h4>Methods</h4>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 as ...[more]

PMID: 35245659

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Project description:BackgroundMultidrug-resistant tuberculosis (MDR-TB) in HIV infected individuals is a serious threat to global efforts to combat tuberculosis. Inconsistent findings on the association between HIV infection and MDR-TB were present in many studies. We aimed to review existing data on the relationship between HIV infection and MDR-TB systematically to assess the contribution of HIV on MDR-TB worldwide. We also investigated the patterns of MDR-TB by age, country-wise income, study designs, and global regions.MethodsWe utilized PubMed, Google Scholar, and ScienceDirect databases to select eligible studies for meta-analysis that were published between January 12,010, and July 30, 2020. The random-effects model was used to obtain the pooled odds ratio of the crude association between HIV and MDR-TB with a 95% confidence interval. We investigated the potential publication-bias by checking funnel plot asymmetry and using the Egger's test. Moreover, we assessed the heterogeneity using the I2 statistic. Sensitivity analysis was performed based on sample size and adjustment factors. The protocol was registered with PROSPERO-CRD42019132752.ResultsWe identified 1603 studies through a database search, and after subsequent eliminations we selected 54 studies including 430,534 TB patients. The pooled odds of MDR-TB was 1.42 times higher in HIV-positive patients than HIV-negative patients (OR=1.42,CI=1.17-1.71, I2=75.8%). Subgroup analysis revealed that the estimated pooled odds for South-East Asian countries was 1.86, which is the highest in WHO regions (OR=1.86,CI=1.30-2.67, I2=0.00%), followed by Europe and Africa. The effect estimate was found to be higher for primary MDR-TB (OR=2.76,CI=1.70-4.46, I2=0.00%). There was also a trend towards increased odds of MDR-TB for HIV patients older than 40 years (OR=1.56,CI=1.17-2.06). The association was found to be significant in high-burden TB countries (OR=1.75, CI=1.39-2.19) and in high-income countries (OR=1.55, CI=1.06-2.27).ConclusionSuch findings indicate that HIV infection raises the risk of MDR-TB, and after contrasting it with the results of the earlier pooled study, it appeared to be an upward risk trend. Moreover, we found that the risk is the highest in the South-East Asian region. A balanced allocation of resources is needed to halt both primary and secondary MDR-TB, particularly in HIV infected people with 40 years of age and older.

Dataset Information

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

Introduction

Methods

Results

Conclusions

Publications

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

Similar Datasets

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