Delamanid is a new anti-tuberculosis drug: use, limitations, and prospects

Зимина, В. Н.; Викторова, И. Б.

doi:10.21292/2075-1230-2021-99-2-58-66

Cited by 7 publications

(3 citation statements)

References 45 publications

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“…Сложность эпидемиологической ситуации по туберкулезу обусловлена ростом лекарственно-устойчивых форм заболевания, в т. ч. множественной и широкой лекарственной устойчивостью. Эта проблема приводит к трудностям при выборе химиотерапии, удлинению сроков ее проведения, а в ряде случаевк низким результатам проводимого специфического лечения [11,12]. При этом наблюдается увеличение распространенных форм туберкулезного процесса, в т. ч. с поражением трахеобронхиального дерева.…”

Section: Discussionunclassified

Integrated Approach in the Treatment of a Patient with Tuberculosis of the Lungs and Tracheobronchial Tree

Chumovatov,

Komissarova,

Chernyh

2024

Урал. мед. журнал

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Introduction. According to the World Health Organization data for 2021, there is an increase in the incidence of tuberculosis (TB) worldwide. There is also an unfavorable growth trend in drug-resistant TB. One of the complications of the tuberculosis process is tuberculosis of the tracheobronchial tree, which has tended to grow in recent years. Many studiesindicate the incidence of bronchial tuberculosis from 10 to 40 %, taking into account the level of endoscopic service.The purpose of the study to demonstrate the high eﬀectiveness of an integrated approach in the treatment of a patient with tuberculosis of the lungs and tracheobronchial tree.Methods. The materials of the study were: the outpatient card of the advisory department of the Central Tuberculosis Research Institute, the medical history of the inpatient patient and the results of a comprehensive examination.Results. The presented clinical example demonstrates the high eﬀectiveness of an integrated approach in the treatment of a patient with a widespread tuberculosis process using anti-tuberculosis chemotherapy, inhalation and pathogenetic therapy. By 4 months of treatment, pronounced positive clinical and laboratory dynamics was observed, signiﬁcant resorption of focal inﬁltrative changes in the leﬅ lung was achieved radiologically, and endoscopically, inﬁltrative tuberculosis of the trachea, leﬅ main bronchus and leﬅ upper lobe bronchus was cured.Conclusion. This clinical observation demonstrates the need for an integrated approach in the management of this category of patients and shows the high eﬀectiveness of the treatment.

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Section: Discussionunclassified

Integrated Approach in the Treatment of a Patient with Tuberculosis of the Lungs and Tracheobronchial Tree

Chumovatov,

Komissarova,

Chernyh

2024

Урал. мед. журнал

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“…One of the main tasks in the fight against the global problem of tuberculosis is the issue of availability of anti-tuberculosis treatment for patients [ 1 , 3 ]. Of particular relevance is using new effective drugs for patients with multiple and extensive drug resistance of the pathogen [ 9 , 10 , 11 ]. According to the WHO report, in the period 2018–2019, around 14 million people worldwide have received TB treatment.…”

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confidence: 99%

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

Старшинова

Dovgalyk

Belyaeva³

et al. 2022

Antibiotics

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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.

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“…Для лечения больных пре-ШЛУ и ШЛУ туберкулезом наибольший интерес представляют новые препараты из групп В и С, значимость которых возросла с связи с ужесточением определений лекарственной устойчивости пре-ШЛУ и ШЛУ, принятых ВОЗ в 2021 г. [16] В 2020 г. в Российской Федерации зарегистрирован в качестве противотуберкулезного препарата для лечения у взрослых туберкулеза легких с МЛУ МБТ новый препарат из группы С -деламанид (Дельтиба; АО «Р-Фарм» и Otsuka Pharmaceutical Co., Ltd.) Деламанид (Dlm) относится к нитроимидазолам и является пролекарством, которое активируется ферментом микобактерий (кофермент F420 -деазафлавин -зависимая нитроредуктаза), образуя в конечном итоге активные формы азота, проявляющие бактерицидное действие, а его метаболиты нарушают синтез миколовой кислоты [1]. Проникая внутрь макрофагов, деламанид оказывает бактерицидное действие не только в отношении активных, но и внутриклеточно локализованных «дремлющих» МБТ.…”

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Specific Parameters of Toxic Reactions in Rats to the Combination of Delamanid and Drugs for Treatment of Drug Resistant Tuberculosis (A Pilot Study)

Можокина

Petrova

Samoilova

et al. 2023

Tuberk. bolezni lëgk.

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The objective: to evaluate the toxicity of combinations of delamanid and drugs for treatment of drug resistant tuberculosis with different safety profiles in an experiment.Results. During 14 days of the study, the animals of both experimental groups satisfactorily tolerated the administration of drug combinations, no animals died, and no negative impact on body weight changes was observed (physiological weight gain). In rats from Group OG-1, the change in the skin color (orange tint) was noted.This change in the tissue color is an adverse reaction, but according to the literature [4], it is reversible. The prolongation of QT interval on ECG in rats treated with the combination of drugs with cardiotoxic potential (Dlm, Bdq, Cfz, Pto) was insignificant, and with the combination of Dlm, Lzd, Cs, Pto did not differ from the baseline level. The neurotoxicity of the combination of Dlm, Lzd, Cs, Pto combination manifested through a decrease in motor and exploratory activity. A decrease in exploratory activity in rats treated with Dlm, Bdq, Cfz, Pto was observed against the background of the preservation of their motor activity. There were no significant changes in laboratory and morphometric parameters in both experimental groups compared to the control group.

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Delamanid is a new anti-tuberculosis drug: use, limitations, and prospects

Cited by 7 publications

References 45 publications

Integrated Approach in the Treatment of a Patient with Tuberculosis of the Lungs and Tracheobronchial Tree

Integrated Approach in the Treatment of a Patient with Tuberculosis of the Lungs and Tracheobronchial Tree

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

Specific Parameters of Toxic Reactions in Rats to the Combination of Delamanid and Drugs for Treatment of Drug Resistant Tuberculosis (A Pilot Study)

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