广泛耐药前结核病(pre-XDR-TB)的流行率上升和治疗效果有限,这凸显了对创新治疗方案的迫切需要。宿主导向疗法(HDT)和抗TB治疗的组合为XDR-TB前管理提供了可行的替代方案。柳氮磺吡啶(SASP),通过靶向氨基酸转运系统xc(xCT),可能减少细胞内结核分枝杆菌负荷并减轻肺部病理,将其定位为有前途的TBHDT代理。本研究旨在评估SASP作为XDR-TB前补充治疗的疗效。
■一项试点研究检查了两个9个月短期疗程的安全性和有效性,用于XDR-TB前治疗的全口服方案:Bdq方案(包括Bdq,利奈唑胺,环丝氨酸,氯法齐明,和吡嗪酰胺)和SASP方案(包括SASP,利奈唑胺,环丝氨酸,氯法齐明,和吡嗪酰胺)。主要终点是治疗后12个月不良结局的发生率。
■在注册的44名参与者中,43在治疗后12个月进行评估。培养物转化率到第2个月为73.2%,到第6个月上升到95.1%。总的来说,88.4%(38/43)的参与者表现出良好的结果,Bdq方案为85.2%(19/23),SASP方案为93.8%(14/15)。SASP方案组无死亡或治疗失败。
■两个9个月的短期课程,全口服治疗方案在治疗XDR-TB前患者方面表现出值得称道的主要疗效.SASP方案是有效的,安全,耐受性良好,和成本效益。
UNASSIGNED: The rising prevalence and limited efficacy of treatments for pre-extensively drug-resistant tuberculosis (pre-XDR-TB) underscore an immediate need for innovative therapeutic options. A combination of host-directed therapy (HDT) and anti-TB treatment presents a viable alternative for pre-XDR-TB management. Sulfasalazine (SASP), by targeting the amino acid transport system xc (xCT), potentially reduces the intracellular Mycobacterium tuberculosis load and mitigates lung pathology, positioning it as a promising TB HDT agent. This study aims to assess the efficacy of SASP as a supplementary therapy for pre-XDR-TB.
UNASSIGNED: A pilot study examined the safety and effectiveness of two 9-month short-course, all-oral regimens for pre-XDR-TB treatment: Bdq-regimen (consisting of Bdq, linezolid, cycloserine, clofazimine, and pyrazinamide) and SASP-regimen (comprising SASP, linezolid, cycloserine, clofazimine, and pyrazinamide). The primary endpoint was the incidence of unfavorable outcomes 12 months post-treatment.
UNASSIGNED: Of the 44 participants enrolled, 43 were assessable 12 months post-treatment. Culture conversion rates stood at 73.2% by Month 2 and escalated to 95.1% by Month 6. Overall, 88.4% (38/43) of the participants exhibited favorable outcomes, 85.2% (19/23) for the Bdq-regimen and 93.8% (14/15) for the SASP-regimen. The SASP-regimen group recorded no deaths or treatment failures.
UNASSIGNED: Both 9-month short-course, all-oral regimens manifested commendable primary efficacy in treating pre-XDR-TB patients. The SASP-regimen emerged as effective, safe, well-tolerated, and cost-effective.