Eur Respir J.: Delamanid for Rifampicin-Resistant Tuberculosis: A Retrospective Study from South Africa.

By Erica Lessem | 09 May, 2018

Dear all,
Please see this article which highlights the importance of availability of
delamanid based on use in a large cohort of patients with
difficult-to-treat MDR-TB.
Erica


Eur Respir J. <https://www.ncbi.nlm.nih.gov/pubmed/29724920> 2018 May 3.
pii: 1800017. doi: 10.1183/13993003.00017-2018. [Epub ahead of print]

*Delamanid for Rifampicin-Resistant Tuberculosis: A Retrospective Study
from South Africa.*

Mohr E
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Mohr%20E%5BAuthor%5D&cauthor=true&c...>
1, Hughes J
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Hughes%20J%5BAuthor%5D&cauthor=true...>
1, Reuter A
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Reuter%20A%5BAuthor%5D&cauthor=true...>
1, Trivino Duran L
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Trivino%20Duran%20L%5BAuthor%5D&cau...>
1, Ferlazzo G
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Ferlazzo%20G%5BAuthor%5D&cauthor=tr...>
2, Daniels J
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Daniels%20J%5BAuthor%5D&cauthor=tru...>
1, De Avezedo V
<https://www.ncbi.nlm.nih.gov/pubmed/?term=De%20Avezedo%20V%5BAuthor%5D&cautho...>
3, Kock Y
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Kock%20Y%5BAuthor%5D&cauthor=true&c...>
4, Jane Steele S
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Jane%20Steele%20S%5BAuthor%5D&cauth...>
5, Shroufi A
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Shroufi%20A%5BAuthor%5D&cauthor=tru...>
5, Ade S
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Ade%20S%5BAuthor%5D&cauthor=true&ca...>
6, Alikhanova N
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Alikhanova%20N%5BAuthor%5D&cauthor=...>
7, Benedetti G
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Benedetti%20G%5BAuthor%5D&cauthor=t...>
8, Edwards J
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Edwards%20J%5BAuthor%5D&cauthor=tru...>
8,9, Cox H
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Cox%20H%5BAuthor%5D&cauthor=true&ca...>
10, Furin J
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Furin%20J%5BAuthor%5D&cauthor=true&...>
11, Isaakidis P
<https://www.ncbi.nlm.nih.gov/pubmed/?term=Isaakidis%20P%5BAuthor%5D&cauthor=t...>
2.

*Author information <https://www.ncbi.nlm.nih.gov/pubmed/29724920>*

*Abstract*

*BACKGROUND: *

Experience with delamanid (Dlm) is limited, particularly among HIV-positive
individuals. We describe early efficacy and safety from a programmatic
setting in South Africa.

*METHODS: *

This was a retrospective cohort study of patients receiving Dlm-containing
treatment regimens between November 2015 and August 2017. Twelve-month
interim outcomes, sputum culture conversion (SCC) by months-2 and 6,
serious adverse events (SAEs), and QTcF data were reported.

*RESULTS: *

Overall, 103 patients initiated Dlm; 79(77%) were HIV-positive. The main
indication for Dlm was intolerance to second-line anti-TB drugs (n=58,
56%). Forty-six patients had 12-months of follow-up; 28(61%) had a
favorable outcome (cure, treatment completion, or culture negativity).
Fifty-seven patients had positive cultures at Dlm initiation; 16/31(52%)
and 25/31(81%) had SCC within 2 and 6-months, respectively. There were 67
SAEs reported in 29(28%) patients. There were four instances of QTcF
prolongation >500 ms in 2(2%) patients, leading to permanent
discontinuation in one case, however no cardiac arrhythmias occurred.

*CONCLUSIONS: *

This large cohort of difficult-to-treat patients receiving Dlm for
rifampicin-resistant tuberculosis treatment in a programmatic setting with
high HIV prevalence had favorable early treatment response and tolerated
treatment well. Dlm should remain available, particularly for those that
cannot be treated with conventional regimens and/or with limited treatment
options.

Copyright ©ERS 2018.

PMID:

29724920

DOI:

10.1183/13993003.00017-2018 <https://doi.org/10.1183/13993003.00017-2018>