<p>Cycloserine for treatment of multidrug-resistant tuberculosis: a retrospective cohort study in China</p>

Abstract

Purpose Cycloserine has been used in multidrug-resistant tuberculosis (MDR-TB) treatment since the 1950s. We evaluated the efficacy and safety of cycloserine and sought to clarify the role of cycloserine for treatment of simple MDR-TB, pre-extensively drug-resistant tuberculosis (pre-XDR-TB), and extensively drug-resistant tuberculosis (XDR-TB). Materials and methods A retrospective observational study was performed in Zhejiang Province, China. We enrolled 144 cycloserine-treated and 181 cycloserine-nontreated patients consecutively and determined the treatment outcome as the primary outcome. The proportion of patients with sputum culture conversion and the frequency of adverse drug reactions were also assessed. Results One-hundred (69.4%) out of 144 patients in the cycloserine group successfully completed treatment. The HR of any unfavorable treatment outcome after the introduction of cycloserine was 0.58 (95% CI: 0.38–0.86, P =0.008). Subgroup analysis showed that cycloser-ine could benefit simple MDR-TB cases reducing the risk of unfavorable treatment outcomes (HR: 0.43, 95% CI: 0.24–0.76, P =0.004), but not pre-XDR-TB (HR: 0.65, 95% CI: 0.30–1.38, P =0.263) or XDR-TB (HR: 0.73, 95% CI: 0.22–2.37, P =0.589). The culture conversion rate at the intensive phase was similar whether cycloserine was administered or not ( P =0.703). Of the 144 patients treated with cycloserine, a total of 16 (11.1%) patients experienced side effects attributed to cycloserine. Conclusion Cycloserine is an attractive agent for the treatment of MDR-TB, and its safety profile warrants its use in most MDR-TB cases. Cycloserine significantly improved the chance of a favorable outcome for patients with simple MDR-TB but not pre-XDR-TB and XDR-TB. Thus, more aggressive regimens might be required for pre-XDR-TB or XDR-TB patients.

An inexpensive, efficient and safe regimen containing Pasiniazid for MDR-TB in high Tuberculosis epidemic areas – A prospective study in China

“…The other drugs made up the regimen, Cs had low resistant rate and Cs containing regimen can achieve a highly successful outcome (66% of cure rate) in China reported by one study (19) and 69.4% of treatment success rate in another study (20). MIC for 90% of the recruited stains were below 32 µg/ml (21).…”

Identification of potential biomarkers and candidate small molecule drugs in glioblastoma

“…Among these, cycloserine and 11deoxy-16,16-dimethylprostaglandin E2 showed highly signi cant negative correlation and might serve as potential drugs for GBM treatment. Cycloserine is a cyclic analog to D-alanine, which can target alanine racemase and d-alanine ligase, thereby preventing the formation of bacterial cell walls [48]. Recently, cycloserine has been widely used in tuberculosis treatment, but no research has focused on the potential role of it in GBM.…”

Neuropsychiatric reactions induced by cycloserine in the treatment of multidrug-resistant tuberculosis: what an Indian female patient tells us

“…A major challenge for this topic is the lack of reference standard to evaluate drug-induced psychiatric events. However, the current knowledge about psychiatric reactions to cycloserine is mainly based on case reports, so further controlled studies are needed 5. A 72-year-old woman with glandular MDR-TB and no history of mental disorders developed psychiatric symptoms after 1 week of treatment with cycloserine (confusion, disturbed sleep, disorientation to time and visual hallucinations).…”

“…In a retrospective observational study performed in China between 2012 and 2015, cycloserine improves the overall favourable outcome of patients with MDR-TB. Among this population, neuropsychiatric adverse events were infrequent (frequency of 11.1%) 5. In this paper, we present a case of a 48-year-old woman with a diagnosis of MDR-TB treated with cycloserine who developed the psychiatric adverse events after 3 months of administration.…”