Outcomes of clofazimine for the treatment of drug-resistant tuberculosis: a systematic review and meta-analysis

Abstract

The available evidence to date suggests that clofazimine could be considered as an additional therapeutic option in the treatment of DR-TB. The optimal dose of clofazimine and duration of use require further investigation.

The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis

“…The drug becomes highly concentrated in fat, organs, and skin with long-term use. 357 Clofazimine accumulation causes slowly reversible red-black skin discolouration in nearly all patients, which is a barrier to widespread implementation because there is a stigma against hyperpigmentation in many countries in which tuberculosis is endemic. The extent of hyperpigmentation and the time to resolution depends on both dose and duration and might, therefore, be mitigated by shorter treatment durations or lower doses, or both, should they prove effective.…”

The role of moxifloxacin in tuberculosis therapy

“…The improved outcome associated with this regimen may be due to the added activity of gatifloxacin compared with ofloxacin often used in the setting of MDR-TB. The inclusion of clofazimine, which has been shown in a systematic review of 12 studies comprising 3489 patients to be effective, could be considered as an additional therapeutic option in the treatment of DR-TB, although it was noted that the optimal dose was yet to be determined [74].…”

Effects of clofazimine on planktonic and biofilm growth of Mycobacterium tuberculosis and Mycobacterium smegmatis

“…When used throughout the entire treatment period, addition of clofazimine has been reported to improve cure rates in the setting of a shorter duration of treatment [14,26,27]. Importantly, similar treatment outcomes both for MDR-TB and extremely drug-resistant TB (XDR-TB) cases have been reported, probably reflecting the low level of resistance to clofazimine [28].…”