ERS/WHO Tuberculosis Consilium assistance with extensively drug-resistant tuberculosis management in a child: case study of compassionate delamanid use

Esposito, Susanna; D’Ambrosio, Lia; Tadolini, Marina; Schaaf, H. Simon; Luna, J.; Marais, Ben J.; Centis, Rosella; Dara, Masoud; Matteelli, Alberto; Blasi, Francesco; Migliori, Giovanni Battista

doi:10.1183/09031936.00060414

Cited by 93 publications

(82 citation statements)

References 17 publications

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“…Unlike bedaquiline, so far, it does not show cross-resistance with the other anti-TB drugs [19,20,52,53]. Some RCTs and observational studies have addressed its efficacy [19,20], and there are also some positive experiences from its compassionate use [54,55]. In the first clinical trial published on delamanid [19], culture conversion at 2 months was more likely to occur in the group that received this drug than in the placebo group.…”

Section: Linezolidmentioning

confidence: 99%

Classification of antituberculosis drugs: a new proposal based on the most recent evidence

Caminero

Scardigli

2015

Eur Respir J

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@ERSpublicationsThe classification of the anti-TB drugs should probably be modified to optimise the use old and new compounds http://ow.ly/QbDSP Multidrug-resistant (MDR) tuberculosis (TB) (resistance to at least isoniazid and rifampicin), with >480 000 cases in 2013, 10% of them being affected by extensively drug-resistant (XDR)-TB (MDR-TB with additional resistance to any fluoroquinolone, and to injectable second-line drugs (SLDs) (capreomycin, kanamycin or amikacin)), continues to represent a real threat to TB control [1][2][3][4]. In some high MDR-TB burden countries, the prevalence of MDR-TB among new cases exceeds 20% and among retreatment cases, reaches almost 50% [1,5].Prevention and quality diagnosis and treatment of MDR-and XDR-TB are part of the crucial interventions included in Pillar 1 of the new World Health Organization (WHO) End TB Strategy, which is focussed on the goal of TB elimination [6][7][8]. Unfortunately, the outcomes of these cases are suboptimal, with 60% success among MDR-TB cases [2], 40% among XDR-TB cases [3] and <20% among the cases with resistance patterns beyond XDR-TB [4]. This means not only high mortality but also significant human suffering and transmission of the Mycobacterium tuberculosis strains within the community [9]. Unfortunately, at present, the treatment of MDR/XDR-TB is still very long, toxic and expensive [10,11].The original WHO guidance on the management of MDR-TB was issued in 1996 [12] and since then, several updated guidelines have been published. The fundamentals on MDR/XDR-TB treatment were published in the 2006 and 2008 WHO guidelines [13,14], where the basic rationale to design therapeutic regimens for these cases was described. According to these recommendations, which are currently followed worldwide, the anti-TB drugs are classified into five main groups indirectly considering the evidence available, the safety and/or the effectiveness of the different drugs. These groups start from the most effective drugs (group 1), grouping the other drugs progressively according to decreasing order of efficacy [15].In the 2011 revision of the WHO MDR/XDR-TB guidelines [16], the composition of different groups of anti-TB drugs was not modified. Therefore, since 2006, the rationale of the classification of the anti-TB drugs has not been changed but several studies have examined the effectiveness, efficacy and safety of the group 5 drugs, and some of these drugs appear to be more effective and well tolerated than others that currently have "higher" ranking in the classification. Furthermore, promising new drugs active against M. tuberculosis have been discovered in the last couple of years [17][18][19][20] and have become progressively available in many parts of the world to treat MDR/XDR-TB.

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Section: Linezolidmentioning

confidence: 99%

Classification of antituberculosis drugs: a new proposal based on the most recent evidence

Caminero

Scardigli

2015

Eur Respir J

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“…Unfortunately, treating MDR-and extensively drug-resistant (XDR)-TB is much more onerous, lengthy and terribly expensive; treatment outcomes remain suboptimal, adverse events being frequent and severe [3][4][5][6]. The availability of new drugs has offered new possibilities for saving patients who were not previously treatable and posed new challenges related to their rational use in order to prevent selection of resistant strains of Mycobacterium tuberculosis [7][8][9][10].…”

Section: Tuberculosis Elimination Patients' Lives and Rational Use Omentioning

confidence: 99%

Tuberculosis elimination, patients' lives and rational use of new drugs: revisited

Tiberi

D’Ambrosio²,

Lorenzo

et al. 2015

Eur Respir J

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“…Recent studies demonstrated that several "areas" relevant for TB elimination are not fully covered in Europe and in Italy [6,7].…”

Section: Is Europe Ready To Reach Tuberculosis Elimination? An Outbrementioning

confidence: 99%

Is Europe ready to reach tuberculosis elimination? An outbreak report from Southern Italy

Gillini

Centis

Fedele³

et al. 2015

Eur Respir J

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ERS/WHO Tuberculosis Consilium assistance with extensively drug-resistant tuberculosis management in a child: case study of compassionate delamanid use

Cited by 93 publications

References 17 publications

Classification of antituberculosis drugs: a new proposal based on the most recent evidence

Classification of antituberculosis drugs: a new proposal based on the most recent evidence

Tuberculosis elimination, patients' lives and rational use of new drugs: revisited

Is Europe ready to reach tuberculosis elimination? An outbreak report from Southern Italy

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