Efficacy of Tuberculosis Treatment in Patients with Drug-Resistant Tuberculosis with the Use of Bedaquiline: The Experience of the Russian Federation

Anna Starshinova; Irina Dovgalyk; Ekaterina Belyaeva; Anzhela Glushkova; Nikolay Osipov; Dmitry Kudlay

doi:10.3390/antibiotics11111622

Efficacy of Tuberculosis Treatment in Patients with Drug-Resistant Tuberculosis with the Use of Bedaquiline: The Experience of the Russian Federation

Antibiotics (Basel). 2022 Nov 14;11(11):1622. doi: 10.3390/antibiotics11111622.

Authors

Anna Starshinova¹, Irina Dovgalyk², Ekaterina Belyaeva³, Anzhela Glushkova⁴, Nikolay Osipov^{5

6}, Dmitry Kudlay^{7

8}

Affiliations

¹ Almazov National Medical Research Centre, 197341 Saint-Petersburg, Russia.
² St. Petersburg Research Institute of Phthisiopulmonology, 191036 Saint-Petersburg, Russia.
³ Republic TB Healthcare Dispensary, 185032 Petrozavodsk, Russia.
⁴ V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, 192019 Saint-Petersburg, Russia.
⁵ St. Petersburg Department of Steklov Mathematical Institute of Russian Academy of Sciences, 191023 Saint-Petersburg, Russia.
⁶ St. Petersburg State University, 199034 Saint-Petersburg, Russia.
⁷ Federal State Autonomous Educational Institution of Higher Education "First Moscow State Medical University Named after I.I. THEM. Sechenov" of the Ministry of Health of Russia (Sechenov University), St. Trubetskaya 8, Building 2, 119048 Moscow, Russia.
⁸ SSC Immunology Institute, 115552 Moscow, Russia.

Abstract

In the conditions of the continued growth of multiple- and extensive drug-resistant tuberculosis, use of the new highly effective anti-tuberculosis drugs in this patient category is of great relevance. The aim of the study was determination the efficacy of treatment in patients with multidrug- and extensive drug-resistant tuberculosis using bedaquiline based on studies published in the Russian Federation.

Materials and methods: The authors analyzed data published in studies from 2014 to 2022; 41 publications were included in total and 17 articles corresponded to the study design. The results of treatment of 1404 tuberculosis patients with MDR/XDR TB were described. Bedaquiline was used according to the standard scheme with a description of the treatment results after 24-26 weeks. Treatment efficacy was estimated according to accepted criteria.

Results of the study: The analysis showed that the treatment efficacy on conversion was achieved in 79.5% of cases (95% Cl 76.5-82.3), and recovery was observed in 82.0% of cases (95% Cl 78.6-85.1). Departure from the therapy was observed in rare cases (9.8%; 95% Cl 7.9-12.2). Deaths were recorded in 6.5% of cases (95% Cl 4.9-8.3), which were associated with the severe disease and concomitant pathology in 74.3%. The development of adverse events was noted in half of the patients (55.7%); however, bedaquiline cancellation occurred in a few cases (7.0%; 95% Cl 3.0-13.0). From analyzing data in patients with MDR and XDR TB, the efficacy of treatment was 89.9% (95% Cl 85.9-93.2) and 71.9% (95% Cl 66.2-77.1), respectively.

Conclusion: Use of bedaquiline in treatment makes it possible to achieve recovery of patients with MDR/XDR TB in 82.0% of cases with patients dropping out of treatment in 9.8%. At the same time, in patients with MDR TB, recovery was achieved in 89.9% of cases, while in patients with XDR TB, 71.9% of cases recovered.

Keywords: bedaquiline; extensive drug resistance; multidrug resistance; mycobacterium tuberculosis; treatment efficacy; tuberculosis.

Publication types

Review

Grants and funding

The calculations were carried out with the support of a grant of the Government of the Russian Federation for the state support of scientific research, carried out under the supervision of leading scientists, agreement 075-15-2021-602.