Academic Journal
Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis
| العنوان: | Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis |
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| المؤلفون: | Ahmad, N., Ahuja, S.D., Akkerman, O.W., Alffenaar, J.C., Anderson, L.F., Baghaei, P., Bang, D., Barry, P.M., Bastos, M.L., Behera, D., Benedetti, A., Bisson, G.P., Boeree, M.J., Bonnet, M., Brode, S.K., Brust, J.C.M., Cai, Y., Caumes, E., Cegielski, J.P., Centis, R., Chan, P.C., Chan, E.D., Chang, K.C., Charles, M., Cirule, A., Dalcolmo, M.P., D'Ambrosio, L., Vries, G. de, Dheda, K., Esmail, A., Flood, J., Fox, G.J., Frechet-Jachym, M., Fregona, G., Gayoso, R., Gegia, M., Gler, M.T., Gu, S., Guglielmetti, L., Holtz, T.H., Hughes, J., Isaakidis, P., Jarlsberg, L., Kempker, R.R., Keshavjee, S., Khan, F.A., Kipiani, M., Koenig, S.P., Koh, W.J., Kritski, A., Kuksa, L., Kvasnovsky, C.L., Kwak, N., Lan, Z., Lange, C de, Laniado-Laborin, R., Lee, M., Leimane, V., Leung, C.C., Leung, E.C., Li, P.Z., Lowenthal, P., Maciel, E.L., Marks, S.M., Mase, S., Mbuagbaw, L., Migliori, G.B., Milanov, V., Miller, A.C., Mitnick, C.D., Modongo, C., Mohr, E., Monedero, I., Nahid, P., Ndjeka, N., O'Donnell, M.R., Padayatchi, N., Palmero, D., Pape, J.W., Podewils, L.J., Reynolds, I., Riekstina, V., Robert, J., Rodriguez, M., Seaworth, B., Seung, K.J., Schnippel, K., Shim, T.S., Singla, R., Smith, S.E., Sotgiu, G., Sukhbaatar, G., Tabarsi, P., Tiberi, S., Trajman, A., Trieu, L., Udwadia, Z.F., Werf, T.S. van der, Veziris, N., Zignol, M., Menzies, D. |
| المصدر: | The Lancet (London), 392, 10150, pp. 821-834 |
| سنة النشر: | 2018 |
| المجموعة: | Radboud University: DSpace |
| مصطلحات موضوعية: | Radboudumc 4: lnfectious Diseases and Global Health RIHS: Radboud Institute for Health Sciences |
| الوصف: | Item does not contain fulltext ; BACKGROUND: Treatment outcomes for multidrug-resistant tuberculosis remain poor. We aimed to estimate the association of treatment success and death with the use of individual drugs, and the optimal number and duration of treatment with those drugs in patients with multidrug-resistant tuberculosis. METHODS: In this individual patient data meta-analysis, we searched MEDLINE, Embase, and the Cochrane Library to identify potentially eligible observational and experimental studies published between Jan 1, 2009, and April 30, 2016. We also searched reference lists from all systematic reviews of treatment of multidrug-resistant tuberculosis published since 2009. To be eligible, studies had to report original results, with end of treatment outcomes (treatment completion [success], failure, or relapse) in cohorts of at least 25 adults (aged >18 years). We used anonymised individual patient data from eligible studies, provided by study investigators, regarding clinical characteristics, treatment, and outcomes. Using propensity score-matched generalised mixed effects logistic, or linear regression, we calculated adjusted odds ratios and adjusted risk differences for success or death during treatment, for specific drugs currently used to treat multidrug-resistant tuberculosis, as well as the number of drugs used and treatment duration. FINDINGS: Of 12 030 patients from 25 countries in 50 studies, 7346 (61%) had treatment success, 1017 (8%) had failure or relapse, and 1729 (14%) died. Compared with failure or relapse, treatment success was positively associated with the use of linezolid (adjusted risk difference 0.15, 95% CI 0.11 to 0.18), levofloxacin (0.15, 0.13 to 0.18), carbapenems (0.14, 0.06 to 0.21), moxifloxacin (0.11, 0.08 to 0.14), bedaquiline (0.10, 0.05 to 0.14), and clofazimine (0.06, 0.01 to 0.10). There was a significant association between reduced mortality and use of linezolid (-0.20, -0.23 to -0.16), levofloxacin (-0.06, -0.09 to -0.04), moxifloxacin (-0.07, -0.10 to ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| Relation: | http://hdl.handle.net/2066/196936; https://doi.org/10.1016/S0140-6736(18)31644-1 |
| DOI: | 10.1016/S0140-6736(18)31644-1 |
| الاتاحة: | http://hdl.handle.net/2066/196936 https://doi.org/10.1016/S0140-6736(18)31644-1 |
| رقم الانضمام: | edsbas.CBB381B8 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/S0140-6736(18)31644-1 |
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