Efficacy of bedaquiline in the treatment of drug-resistant tuberculosis: a systematic review and meta-analysis
Open Access
- 17 September 2021
- journal article
- review article
- Published by Springer Science and Business Media LLC in BMC Infectious Diseases
- Vol. 21 (1), 1-10
- https://doi.org/10.1186/s12879-021-06666-8
Abstract
Drug-resistant tuberculosis (DR-TB) remains a major public health concern worldwide. Bedaquiline, a novel diarylquinoline, was added to the WHO-recommended all-oral regimen for patients with multidrug-resistant tuberculosis. We performed a systematic review and meta-analysis to determine the effect of bedaquiline on tuberculosis treatment outcomes. We searched the PubMed, Web of Science and EMBASE databases for relevant studies published up to March 12, 2021. We included studies in which some participants received bedaquiline and others did not. Stata version 16.0 (Stata Corp., College Station, Texas, USA) was used to analyze the results of the meta-analysis. Risk ratios (RRs) with 95% confidence intervals (95% CIs) were calculated to evaluate the effect of bedaquiline on drug-resistant tuberculosis. Between-study heterogeneity was examined by the I-squared test. Randomized controlled trials were assessed for quality using the Jadad scale, and cohort studies were assessed using the Newcastle–Ottawa scale. Eight studies, including 2 randomized controlled trials and 6 cohort studies involving a total of 21,836 subjects, were included. When compared with the control, bedaquiline treatment was associated with higher rates of culture conversion (risk ratio (RR):1.272 (1.165–1.389), P < 0.001). We found substantial evidence of a significant reduction in all-cause death (RR: 0.529 (0.454–0.616), P < 0.001)) in the bedaquiline treatment group. There was no significant reduction in treatment success (RR = 0.980 (0.948–1.013, P = 0.234)). This study demonstrated that compared with patients who do not receive bedaquiline, this drug has the potential to achieve a higher culture conversion rate and a lower mortality risk among drug-resistant tuberculosis cases.Keywords
Funding Information
- National Natural Science Foundation of China (81870015)
This publication has 25 references indexed in Scilit:
- Bedaquiline in the treatment of multidrug- and extensively drug-resistant tuberculosisEuropean Respiratory Journal, 2015
- Additional Drug Resistance of Multidrug-Resistant Tuberculosis in Patients in 9 CountriesEmerging Infectious Diseases, 2015
- Bactericidal mode of action of bedaquilineJournal of Antimicrobial Chemotherapy, 2015
- Compassionate Use of Bedaquiline for the Treatment of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis: Interim Analysis of a French CohortClinical Infectious Diseases, 2014
- WHO guidelines for the programmatic management of drug-resistant tuberculosis: 2011 updateEuropean Respiratory Journal, 2011
- TMC207: the first compound of a new class of potent anti-tuberculosis drugsFuture Microbiology, 2010
- Diarylquinolines target subunit c of mycobacterial ATP synthaseNature Chemical Biology, 2007
- Measuring inconsistency in meta-analysesBMJ, 2003
- Assessing the quality of reports of randomized clinical trials: Is blinding necessary?Controlled Clinical Trials, 1996