Experience of treating extensive drug resistant tuberculosis patients including continuous use of bedaquiline, in Tomsk Region: immediate and postponed results

The objective of the study: to evaluate the efficacy and safety of treatment of tuberculosis patients with pre-extensive drug resistance and extensive drug resistance (XDR-TB) with regimen V using new anti-tuberculosis drugs including continuous treatment with bedaquiline.

Subjects and methods. The treatment efficacy and safety were assessed in 39 patients treated with regimen V. Of them, 17 (43.6%) suffered from fibrous cavernous tuberculosis, 31 (79.5%), and 9 (23.1%) were HIV positive.

Results. Treatment efficacy: 32 (82.0%) were cured, 1 (2.6%) was treatment failure, 4 (10.2%) did of non-tuberculosis, 2 (5.1%) defaulted from treatment. 23 (69.7%) patients took bedaquiline for the entire course of chemotherapy (the average duration made 19.3 months). Of them, 22 (95.6%) were cured, 1 (4.4%) had treatment failed. It was observed that the drug was well tolerated.

Adverse events resulted in the cancellation of drugs were documented in 9 (23.1%) patients. After sputum conversion, 30 (76.9%) patients were treated using hospital-substituting technologies, including 10 of them who were treated under direct observation by video. Post-treatment follow-up is carried out in 28 out of 32 (2 changed their place of residence, 2 died of non-tuberculosis) of the treated patients, the average duration of follow-up have made 11.7 ± 6.3 months, the patients are relapse free.

1. Borisov S.E., Fillipov А.V., Ivanova D.А., Ivanushkina T.N., Litvinova N.V., Garmash Yu.Yu. Efficacy and safety of chemotherapy regimens with bedaquiline in patients with respiratory tuberculosis: immediate and final results. Tuberculosis and Lung Diseases, 2019, vol. 97, no. 5, pp. 28-40. (In Russ.)

2. Gayda А.I., Sveshnikova O.M., Verkhovaya V.N., Makhmaeva S.V., Nikishova E.I., Maryandyshev А.O. Treatment of tuberculosis patients with extensive drug resistance using new anti-tuberculosis drugs in the civilian community of Arkhangelsk Region. Tuberculosis and Lung Diseases, 2018, vol. 96, no. 7, pp. 5-9. (In Russ.)

3. Kondakova M.N., Khabirov V.V., Zhemkov V.F., Shpakovskaya L.R., Daynovets А.V., Elkin А.V. Impact of bedaquiline on the efficacy of comprehensive therapy of respiratory tuberculosis. Tuberculosis and Lung Diseases, 2018, vol. 96, no. 6, pp. 39-43. (In Russ.)

4. Konovalova N.M., Odinets V.S., Vasilenko T.I., Zadremaylova T.А. Experience of using bedaquiline in the treatment of pulmonary tuberculosis patients with multiple and extensive drug resistance. Tuberculosis and Lung Diseases, 2017, vol. 95, no. 12, pp. 49-53. (In Russ.)

5. Mamaev А.N., Kudlay D.А. Vizualizatsiya dannykh v prezentatsiyakh, otchetakh i issledovaniyakh. [Data visualization in presentations, reports and trials]. Moscow, Prakticheskaya Meditsina Publ., 2011, 39 p.

6. Otraslevye i ekonomicheskie pokazateli protivotuberkuleznoy raboty v 2016-2017 gg. Analiticheskiy obzor osnovnykh pokazateley i statisticheskiye materialy. [Sectorial and economic rates for TB control in 2016-2017. Analysis of main rates and statistic materials]. S.A. Sterlikov, eds., Moscow, RIO TSNIIOIZ Publ., 2018, 81 p.

7. Tikhonov А.M., Burakova M.V., Vaniev E.V., Romsanov V.V., Vasilyeva I.А. Efficiency of chemotherapy with bedaquiline in drug resistant pulmonary tuberculosis patients. Tuberculosis and Lung Diseases, 2018, vol. 96, no. 2, pp. 22-26. (In Russ.)

8. Tikhonova L.Yu., Sokolova V.V., Tarasyuk I.А., Ekimenko А.M., Cherenkova M.А., Kudlay D.А. Experience of treatment of multiple drug resistant tuberculosis patients with bedaquiline in Amur Region. Tuberculosis and Lung Diseases, 2018, vol. 96, no. 6, pp. 45-50. (In Russ.)

9. Global tuberculosis report 2018, Geneva: World Health Organization, 2018; 95-96.