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KMID : 0370220170610020124
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Yakhak Hoeji
2017 Volume.61 No. 2 p.124 ~ p.134
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Efficacy and Safety of Bedaquiline and Delamanid in the Treatment of Tuberculosis: a Focus on Multidrug-resistant Tuberculosis
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Yang Young-Mo
Choi Eun-Joo
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Abstract
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The emergence of multi-drug resistant tuberculosis (MDR-TB) poses a major difficulty in controlling TB worldwide. More potent TB drugs, higher cost, and longer duration of treatment are necessary for MDR-TB compared with drug-sensitive TB. However, currently available TB drugs have been used for more than 40 years. Therefore, a novel anti-TB drug is required for the treatment of MDR-TB. This study was aimed at assessing the efficacy and safety of bedaquiline and delamanid and determining the therapeutic validity of them in controlling MDR-TB. A literature search of original studies published in PubMed, MEDLINE, and Scopus until August 2015 was conducted using the terms ‘bedaquiline OR delamanid’ AND ‘efficacy OR safety’ AND ‘tuberculosis’ to identify the clinical trials regarding bedaquiline or delamanid in TB. Six and four clinical studies regarding bedaquiline and delamanid, respectively, were examined in this review. The treatment durations of bedaquiline and delamanid in the selected studies were from 2 weeks to 32 weeks. The higher falls in log10 colony forming units (CFU)/mL during the treatment period were observed in the regimens including bedaquiline than in the standard anti-TB regimen. The median time to sputum-culture conversion (TTC) of the bedaquiline group was shorter than that of the placebo group. The sputum-culture conversion rate of the delamanid group was higher than that of the placebo group. In the included studies, serious adverse effects were not reported due to bedaquiline or delamanid. However, their uses were more highly associated with potential QT-interval prolongation. The clinical trials suggest that the uses of bedaquiline or delamanid with other anti-TB medications were at least efficacious and safe in the treatment of MDR-TB at this point.
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KEYWORD
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multidrug-resistant tuberculosis, MDR-TB, bedaquiline, delamanid, efficacy, safety
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