Clofazimine improves clinical outcomes in multidrug-resistant tuberculosis: a randomized controlled trial

被引:22
|
作者
Duan, H. [1 ]
Chen, X. [2 ]
Li, Z. [3 ,14 ]
Pang, Y. [4 ]
Jing, W. [1 ]
Liu, P. [5 ]
Wu, T. [6 ]
Cai, C. [7 ]
Shi, J. [8 ]
Qin, Z. [8 ]
Yin, H. [9 ]
Qiu, C. [10 ]
Li, C. [11 ]
Xia, Y. [11 ]
Chen, W. [12 ]
Ye, Z. [13 ]
Li, Z. [3 ,14 ]
Chen, G. [15 ]
Wang, S. [16 ]
Liu, Y. [17 ]
Chu, L. [18 ]
Zhu, M. [19 ]
Xu, T. [20 ,21 ]
Wang, Q. [1 ]
Wang, J. [1 ]
Du, Y. [1 ]
Wang, J. [1 ]
Chu, N. [1 ]
Xu, S. [22 ]
机构
[1] Capital Med Univ, Dept TB, Beijing Chest Hosp, Beijing TB & Thorac Tumour Res Inst, Beijing, Peoples R China
[2] Pulm Hosp Fuzhou Fujian Prov, Dept TB, Fuzhou, Fujian, Peoples R China
[3] Hebei Chest Hosp, Dept TB, Shijiazhuang, Hebei, Peoples R China
[4] Capital Med Univ, Natl Clin Lab TB, Beijing Chest Hosp, Beijing TB & Thorac Tumour Res Inst, Beijing, Peoples R China
[5] Peoples Hosp Changshou Distirct, Dept Resp Med, Chongqing, Peoples R China
[6] Chongqing Med Univ, Dept Resp Med, Affiliated Hosp Chengdu 2, Chongqing, Peoples R China
[7] Guiyang Pulm Hosp, Dept TB, Guiyang, Guizhou, Peoples R China
[8] Sixth Peoples Hosp Nantong City Jiangsu Prov, Dept TB, Nantong, Peoples R China
[9] Tongji Univ, Dept TB, Shanghai Pulm Hosp, Shanghai, Peoples R China
[10] Jiamusi TB Control Hosp, Dept Drug Resistant TB, Jiamusi, Peoples R China
[11] Changsha Cent Hosp, Ward Pulm Hosp 3, Changsha, Hunan, Peoples R China
[12] Shenyang Chest Hosp, Dept TB, Shenyang, Liaoning, Peoples R China
[13] Xiamen Univ, Dept Pulm, Affiliated Hosp 1, Xiamen, Peoples R China
[14] Liaoyang TB Hosp Liaoning Prov, Dept TB, Liaoyang, Peoples R China
[15] Chongqing Pulm Hosp, Dept TB, Chongqing, Peoples R China
[16] Chest Hosp Xinjiang Uyghur Autonomous Reg PRC, Dept Thorac Surg, Urumqi, Peoples R China
[17] Qingdao Chest Hosp, Dept Chest, Qingdao, Peoples R China
[18] Seventh Peoples Hosp Mudanjiang, Dept TB, Mudanjiang, Peoples R China
[19] Hangzhou Red Cross Hosp, TB Treatment Ctr, Hangzhou, Zhejiang, Peoples R China
[20] Chinese Acad Med Sci, Dept Epidemiol & Biostat, Inst Basic Med Sci, Beijing, Peoples R China
[21] Peking Union Med Coll, Sch Basic Med, Beijing, Peoples R China
[22] Capital Med Univ, Dept Thorac Surg, Beijing Chest Hosp, Beijing TB & Thorac Tumor Res Inst, Beijing, Peoples R China
关键词
Adverse events; China; Clofazimine; Multidrug-resistant tuberculosis; Treatment; NATIONAL-SURVEY; DRUG-TREATMENT; MDR-TB; BEDAQUILINE;
D O I
10.1016/j.cmi.2018.07.012
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: We carried out a randomized multicentre study in China to investigate whether the clofazimine would improve the efficacy of the standardized regimen in patients with multidrug-resistant tuberculosis (MDR-TB). Methods: Patients with MDR-TB managed in 17 TB specialist hospitals in China between September 2009 and September 2011 were randomly assigned to the treatment groups at enrolment. In the intervention group, 100 mg clofazimine per day was added to the standardized regimen. The primary outcome was the proportion of patients with successful outcomes. Results: From the 156 patients that were screened, 74 were assigned to the control group and 66 to the clofazimine group. Of the 66 cases analysed for clinical outcome in the clofazimine group, 36 patients were cured, and seven completed treatment, yielding a favourable outcome rate of 65.1%. The proportion of patients with favourable outcomes receiving the control regimen was 47.3% (35/74), which was significantly lower than that in the clofazimine group (p 0.034, relative risk 0.661, 95% CI 0.243-0.949). Conclusions: The addition of clofazimine to the standard regimen improved the treatment of MDR-TB. (C) 2018 Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.
引用
收藏
页码:190 / 195
页数:6
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