PDF(Pubmed)
Abstract：
UNASSIGNED: Treatment for rifampicin-resistant tuberculosis (RR-TB) has been shortened to 12 months or less, with duration depending on the regimen used and treatment response. Treatment shortening has the potential to increase the risk of relapse, with a new episode of RR-TB after cure or completion. The proportion of relapses after standardized all-oral short (12 months or less) RR-TB regimens has not yet been systematically reviewed, which is the main objective of this review.
UNASSIGNED: This is a systematic review and meta-analysis. PubMed, Web of Science and Google scholar databases were systematically investigated to identify studies published between January 2018 and November 2023. Characteristics of studies, demographic data, baseline clinical condition, resistance profile, and definitions used for relapse, failure, and end-of-treatment outcomes are summarized in tables and graphs. Pooled proportions are estimated for relapse.
UNASSIGNED: A total of ten studies were included in this review and meta-analysis, representing 1792 participants. Seven studies were clinical trials and two were cohorts. Five studies investigated all-oral six-month regimens composed of bedaquiline, pretomanid, and linezolid (BPaL). The remaining studies assessed other standardized all-oral short regimens, with treatment duration between 6 and 12 months. Post-treatment follow-up (PTFU) duration ranged from 6 to 30 months. The pooled proportion estimate of relapse was 2·0% (95 % CI, 1·0-3·0%) for all and BPaL-based regimens. Treatment extension due to poor treatment response was poorly documented.
UNASSIGNED: This review showed that the proportion of relapse in RR-TB patients treated with standardized short all-oral regimens was low. The low relapse proportion is similar to what was achieved for drug-susceptible Tuberculosis patients treated with first-line rifampicin-containing regimens. However, most data came from trial settings, and in some studies the post-treatment follow-up was short. Studies of large programmatic cohorts with longer post-treatment follow-up periods are needed to confirm the low relapse rate shown in the clinical trials.
UNASSIGNED: This is a systematic review and meta-analysis. PubMed, Web of Science and Google scholar databases were systematically investigated to identify studies published between January 2018 and November 2023. Characteristics of studies, demographic data, baseline clinical condition, resistance profile, and definitions used for relapse, failure, and end-of-treatment outcomes are summarized in tables and graphs. Pooled proportions are estimated for relapse.
UNASSIGNED: A total of ten studies were included in this review and meta-analysis, representing 1792 participants. Seven studies were clinical trials and two were cohorts. Five studies investigated all-oral six-month regimens composed of bedaquiline, pretomanid, and linezolid (BPaL). The remaining studies assessed other standardized all-oral short regimens, with treatment duration between 6 and 12 months. Post-treatment follow-up (PTFU) duration ranged from 6 to 30 months. The pooled proportion estimate of relapse was 2·0% (95 % CI, 1·0-3·0%) for all and BPaL-based regimens. Treatment extension due to poor treatment response was poorly documented.
UNASSIGNED: This review showed that the proportion of relapse in RR-TB patients treated with standardized short all-oral regimens was low. The low relapse proportion is similar to what was achieved for drug-susceptible Tuberculosis patients treated with first-line rifampicin-containing regimens. However, most data came from trial settings, and in some studies the post-treatment follow-up was short. Studies of large programmatic cohorts with longer post-treatment follow-up periods are needed to confirm the low relapse rate shown in the clinical trials.
摘要：
■利福平耐药结核病（RR-TB）的治疗已缩短至12个月或更短，持续时间取决于使用的方案和治疗反应。缩短治疗有可能增加复发的风险，治愈或完成后出现新的RR-TB。标准化全口服短期（12个月或更短）RR-TB方案后复发的比例尚未进行系统评估，这是这次审查的主要目的。
■这是一项系统的综述和荟萃分析。PubMed,对WebofScience和Google学者数据库进行了系统调查，以确定2018年1月至2023年11月之间发表的研究。研究的特点，人口统计数据，基线临床状况，电阻剖面,以及用于复发的定义，失败,和治疗结束结果汇总在表格和图表中.估计复发的汇集比例。
■本综述和荟萃分析共纳入了10项研究，代表1792名参与者。七项研究是临床试验，两项是队列。五项研究调查了由bedaquiline组成的全口服六个月治疗方案，Pretomanid,和利奈唑胺（BPaL）。其余研究评估了其他标准化的全口服短期治疗方案，治疗时间在6到12个月之间。治疗后随访（PTFU）时间为6至30个月。对于所有和基于BPaL的方案，复发的合并比例估计为2·0％（95％CI，1·0-3·0％）。由于治疗反应不佳而导致的治疗延长记录不佳。
■本综述显示，使用标准化短口服方案治疗的RR-TB患者的复发比例较低。低复发比例与使用含利福平一线方案治疗的药物敏感型结核病患者相似。然而,大多数数据来自试用设置，在一些研究中，治疗后的随访时间很短。需要对治疗后随访时间较长的大型计划队列进行研究，以确认临床试验中显示的低复发率。
■这是一项系统的综述和荟萃分析。PubMed,对WebofScience和Google学者数据库进行了系统调查，以确定2018年1月至2023年11月之间发表的研究。研究的特点，人口统计数据，基线临床状况，电阻剖面,以及用于复发的定义，失败,和治疗结束结果汇总在表格和图表中.估计复发的汇集比例。
■本综述和荟萃分析共纳入了10项研究，代表1792名参与者。七项研究是临床试验，两项是队列。五项研究调查了由bedaquiline组成的全口服六个月治疗方案，Pretomanid,和利奈唑胺（BPaL）。其余研究评估了其他标准化的全口服短期治疗方案，治疗时间在6到12个月之间。治疗后随访（PTFU）时间为6至30个月。对于所有和基于BPaL的方案，复发的合并比例估计为2·0％（95％CI，1·0-3·0％）。由于治疗反应不佳而导致的治疗延长记录不佳。
■本综述显示，使用标准化短口服方案治疗的RR-TB患者的复发比例较低。低复发比例与使用含利福平一线方案治疗的药物敏感型结核病患者相似。然而,大多数数据来自试用设置，在一些研究中，治疗后的随访时间很短。需要对治疗后随访时间较长的大型计划队列进行研究，以确认临床试验中显示的低复发率。
