菲律宾BPaL疗法的有效性和安全性
Irene Flores1,2, Maria Imelda Quelapio3,4, Charlotte Cabalitan2,5
1Jose B. Lingad Memorial General Hospital, San Fernando City, Pampanga, Philippines.
Journal of clinical tuberculosis and other mycobacterial diseases
|October 28, 2025
概括
在菲律宾的多药耐药结核病患者中,BPaL疗法获得了98%的治疗成功,显示出快速的培养转换和可管理的安全性. 这为难以治疗的肺结核病例提供了一个有希望的新选择.
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:
- 之前在菲律宾进行了为期9个月的全口服治疗多药耐药/反素耐药结核病 (MDR/RR-TB) 方案,其成功率低于最佳水平.
- 患者经历了较旧的MDR/RR-TB治疗方案带来的负担和毒性影响.
- 世界卫生组织建议在2022年使用6个月的MDR-TB疗法 (BPaL).
研究的目的:
- 评估菲律宾MDR/RR-TB患者6个月BPaL治疗方案的有效性和安全性.
- 评估治疗成功率,培养转换和与BPaL疗法相关的不良事件.
- 确定在现实临床环境中实施BPaL治疗方案的可行性.
主要方法:
- 在菲律宾10个地区的12个结核病治疗中心进行了运营研究.
- 在2021年6月至2022年12月期间,预先患有广泛耐药结核病或治疗不耐受/不反应的MDR/RR-TB的患者被纳入.
- 林涅佐利德每天服用1200毫克或600毫克.
主要成果:
- 共有103名患者接受了BPaL治疗方案,其中96人被纳入队列分析.
- 治疗成功率为98%,尽管诺基诺隆耐药性高 (42%),洞腔结核病 (31%),糖尿病 (42%) 和艾滋病毒共感染率高 (8%).
- 唾液培养的转化速度很快 (第1个月为78%,第4个月为96%),治疗后的持续成功率很高 (90-92%).
结论:
- 在MDR/RR-TB患者中,BPaL疗法表现出非常高的治疗成功率和快速的培养转化.
- 该疗法表现出可管理的安全性概况,大多数不良事件为1-2级,并完全消失.
- BPaL疗法是治疗MDR/RR-TB的可行且有效的选择,即使是在具有显著并发症和耐药性模式的患者中也是如此.
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