One Step Forward: Successful End-of-Treatment Outcomes of Patients With Drug-Resistant Tuberculosis Who Received Concomitant Bedaquiline and Delamanid in Mumbai, India

Das, Mrinalini; Dalal, Alpa; Laxmeshwar, Chinmay; Ravi, Shilpa; Mamnoon, Fatima; Meneguim, Augusto C; Paryani, Roma; Mathur, T. N.; Singh, Phirtu; Mansoor, Homa; Kalon, Stobdan; Hossain, Farah; Lachenal, Nathalie; Coutisson, Sylvine; Ferlazzo, Gabriella; Isaakidis, Petros

doi:10.1093/cid/ciaa1577

Cited by 22 publications

(16 citation statements)

References 18 publications

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“…Of these, 42 articles were selected for a full-text review. After the full-text review, 25 articles met the inclusion criteria (Auchynka et al, 2021;Chang et al, 2018;Das et al, 2020;Das et al, 2021;Dooley et al, 2021;Ferlazzo et al, 2018;Ghosh et al, 2021;Gler et al, 2012;Häcker et al, 2020;Hafkin et al, 2017, Hafkin et al, 2019Hewison et al, 2017;Kang et al, 2020;Kim et al, 2018;Kuksa et al, 2017;Kwon et al, 2021;Lee et al, 2020;Madzgharashvili et al, 2021;Mohr-Holland et al, 2020;Mok et al, 2019;Olayanju et al, 2020;Pirmahmadzoda et al, 2021;Sarin et al, 2019;Solodovnikova et al, 2021;von Groote-Bidlingmaier et al, 2019) of which 22 were observational (with 1,276 patients) (Auchynka et al, 2021;Chang et al, 2018;Das et al, 2020;Das et al, 2021;Ferlazzo et al, 2018;Ghosh et al, 2021;Häcker et al, 2020;Hafkin et al, 2017;Hafkin et al, 2019;Hewison et al, 2017;Kang et al, 2020;Kim et al, 2018;Kuksa et al, 2017;Kwon et al, 2021;…”

Section: Resultsmentioning

confidence: 99%

Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis

Nasiri

Zangiabadian

Arabpour

et al. 2022

International Journal of Infectious Diseases

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Section: Resultsmentioning

confidence: 99%

Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis

Nasiri

Zangiabadian

Arabpour

et al. 2022

International Journal of Infectious Diseases

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“…report on a cohort of patients with complex TB resistance patterns, many on a regimen with new TB drugs, and previously exposed for a long duration to TB treatment [22]. We observed a significantly higher proportion of psychiatric comorbidities among newly diagnosed people with DR-TB than those previously treated.…”

Section: Plos Onementioning

confidence: 74%

“…The MSF clinic has provided free-of-cost care to DR-TB patients since 2007 [21,22]. The clinic receives patients with complex TB resistance patterns who are referred from public and private healthcare institutions.…”

Section: Study Settingmentioning

confidence: 99%

See 1 more Smart Citation

Psychiatric comorbidities among patients with complex drug-resistant tuberculosis in Mumbai, India

Laxmeshwar¹,

Das²,

Mathur³

et al. 2022

PLoS ONE

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Background People with drug-resistant tuberculosis (DR-TB) are known to suffer from many mental-health disorders. This study aims to describe the proportion of patients diagnosed with psychiatric comorbidities, the different psychiatric diagnoses made, and treatment outcomes among DR-TB patients with or without psychiatric comorbidity and initiated on DR-TB treatment between January 2012 and March 2019 at Médecins Sans Frontières independent clinic in Mumbai, India. Methods This is a retrospective study using routinely collected clinical data. DR-TB care included individualised treatment, psychosocial support, and integrated psychiatric care. Results During the study period, 341 DR-TB patients were enrolled, with a median age of 25 years (IQR:20.0–36.5 years), 185 (54.2%) females, 143 (41.9%) with PreXDR-TB, and 140 (41.0%) with XDR-TB. All 341 patients were screened by a counsellor, 119 (34.9%) were referred for psychiatric evaluation, and 102 (29.9% of 341) were diagnosed with a psychiatric comorbidity. Among 102 diagnosed with a psychiatric comorbidity, 48 (47.0%) were diagnosed at baseline, and 86 (84.3%), or 25.2% of all 341 patients enrolled, were treated with psychotropic drugs. Depressive disorders were diagnosed in 49 (48.0%), mixed anxiety and depression in 24 (23.5%), neurocognitive disorders and anxiety in five (4.9%), and medication induced psychosis in two (2.0%). No anti-TB drugs were significantly associated with psychiatric comorbidities developed during treatment. Of 102 DR-TB patients with a psychiatric comorbidity, 75.5% (77) had successful DR-TB treatment outcomes, compared to 61.1% (146/239) not diagnosed with a psychiatric comorbidity (p = 0.014). Conclusion In our setting, among people started on DR-TB treatment, and with a complex TB resistance profile, about one in three patients experienced a psychiatric comorbidity, of which half developed this comorbidity during treatment. With comprehensive psychiatric care integrated into DR-TB care delivery, treatment outcomes were at least as good among those with psychiatric comorbidities compared to those without such comorbidities.

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“…In another retrospective cohort study conducted in Mumbai, India, treatment outcomes on 49 (70%) patients who received BDQ-DLM combination regimen for 24 weeks were represented to be successful. The majority (69%) of patients showed culture conversion, and effective end-of-treatment results were reported in 49 (70%) patients (Das et al, 2020a).…”

Section: Synergism Of Delamanid With Other Antituberculosis Drugsmentioning

confidence: 98%

Mechanism of Action, Resistance, Synergism, and Clinical Implications of Delamanid Against Multidrug-Resistant Mycobacterium tuberculosis

et al. 2021

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Multidrug-resistant (MDR) isolates of Mycobacterium tuberculosis (MTB) remain a primary global threat to the end of tuberculosis (TB) era. Delamanid (DLM) is a nitro-dihydro-imidazooxazole derivative utilized to treat MDR-TB. DLM has distinct mechanism of action, inhibiting methoxy- and keto-mycolic acid (MA) synthesis through the F420 coenzyme mycobacteria system and generating nitrous oxide. While DLM resistance among MTB strains is uncommon, there are increasing reports in Asia and Europe, and such resistance will prolong the treatment courses of patients infected with MDR-TB. In this review, we address the antimycobacterial properties of DLM, report the global prevalence of DLM resistance, discuss the synergism of DLM with other anti-TB drugs, and evaluate the documented clinical trials to provide new insights into the clinical use of this antibiotic.

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One Step Forward: Successful End-of-Treatment Outcomes of Patients With Drug-Resistant Tuberculosis Who Received Concomitant Bedaquiline and Delamanid in Mumbai, India

Cited by 22 publications

References 18 publications

Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis

Delamanid-containing regimens and multidrug-resistant tuberculosis: A systematic review and meta-analysis

Psychiatric comorbidities among patients with complex drug-resistant tuberculosis in Mumbai, India

Mechanism of Action, Resistance, Synergism, and Clinical Implications of Delamanid Against Multidrug-Resistant Mycobacterium tuberculosis

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