符合世卫组织的,更长的,全口服多药耐药结核病疗法的结果和分析影响
1Division of Global Health Equity, Brigham and Women´s Hospital, Boston, MA, Partners In Health, Boston, MA, USA.
概括
针对多药耐药结核病 (MDR/RR-TB) 的较长时间的个性化治疗方案显示了高的治疗成功率. 然而,由于疗法组合的多样性,直接比较很难,这凸显了对最佳药物组合的进一步研究的需要.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 关于世卫组织推的长时间个性化治疗方案对抗多药或利芬辛耐药结核病 (MDR/RR-TB) 的有效性,证据有限.
- 评估MDR/RR-TB治疗结果需要了解各种治疗方案的复杂性.
研究的目的:
- 报告MDR/RR-TB患者的治疗结束结果,使用多国队列 (2015-2018).
- 评估与当前的2022年世卫组织更新的MDR/RR-TB治疗建议相一致的治疗方案.
- 描述比较不同MDR/RR-TB治疗方案所面临的挑战.
主要方法:
- 从终端TB观察研究中对参与者的子集进行分析.
- 纳入标准:启动较长的MDR/RR-TB治疗方案,符合2022年世卫组织指南.
- 排除标准:使用注射剂或使用不到四种可能有效的药物.
主要成果:
- 在759名参与者中,有607名 (80.0%) 获得了成功的治疗结束结果.
- 在各个子组中观察到高成功率 (72.1%至90.0%),包括那些按A组药物或诺基诺隆耐药性分层的子组.
- 在治疗方案组成和个体药物持续时间方面注意到了显著的变化.
结论:
- 较长的,全口服的,个性化的MDR/RR-TB疗法与2022年世卫组织指导一致,证明了高治疗成功率.
- 异质的治疗方案组成和药物持续时间阻碍了有意义的比较分析.
- 未来的研究应该集中在确定药物组合,以优化MDR/RR-TB的安全性,耐受性和有效性.
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