Early safety and efficacy of linezolid-based combination therapy among patients with drug-resistant tuberculosis in North-western Nigeria
Early safety and efficacy of linezolid-based combination therapy among patients with drug-resistant tuberculosis in North-western Nigeria
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DOI：
10.4103/ijmy.ijmy_57_21
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发表时间：
2021-04-01
影响因子：
1.2
通讯作者：
Habib, Abdulrazaq Garba
中科院分区：
文献类型：
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作者：
Dayyab, Farouq Muhammad;Iliyasu, Garba;Habib, Abdulrazaq Garba
背景：耐药结核病的出现继续对撒哈拉以南非洲和全球的公共卫生构成威胁。尽管尼日利亚的结核病(TB)负担很重，但关于用于治疗DRTB的新药和重新调整用途的药物的安全性和有效性的数据很少。方法：这项前瞻性队列研究是在尼日利亚西北部卡诺市的一个区域DRTB治疗中心进行的。数据分析采用描述性统计、Mann-Whitney U检验和卡方检验或Fisher‘s精确检验。结果：患者的中位年龄为32岁(四分位数范围26-42岁)。39例患者中，男性34例(87.18%)。患者以农村居多，占64.10%。开始联合治疗10个月时，25例(64.10%)患者存活，培养阴性，仍在治疗中，14例(35.90%)死亡。在队列中的39名患者中，26名患者(66.67%)至少有一次严重不良事件。最常见的严重不良事件是血液系统疾病(35.14%)和神经系统疾病(29.73%)。在利奈唑胺阻断剂中，周围神经病变(P<；0.0001)、贫血(P=0.029)和皮肤反应(P=0.021)的发生率更高。结论：在以利奈唑胺为基础的联合治疗基础上，每天给予利奈唑胺600 mg，10个月的培养转换率令人满意。然而，利奈唑胺可能与周围神经病变有关，可能需要停药。
Background: The emergence of drug-resistant tuberculosis (DRTB) has continued to pose a threat to public health in sub-Saharan Africa and globally. Despite the high burden of tuberculosis (TB) in Nigeria, there are paucity of data on the safety and efficacy of newer agents and repurposed drugs used in the treatment of DRTB. Methods: This prospective cohort study was conducted at a regional DRTB treatment center in Kano, Northwestern Nigeria. Descriptive statistics, Mann-Whitney U-test, and Chi-square or Fisher's exact test were used to analyze the data as appropriate. Results: The median age of the patients was 32 years (interquartile range 26-42 years). Of the 39 patients, 34 (87.18%) were males. The majority of the patients came from the rural areas 25 (64.10%). By 10 months of initiation of combination therapy, 25 (64.10%) of the patients were alive, culture negative and on treatment while 14 (35.90%) of the patients have died. Out of the 39 patients in the cohort, 26 (66.67%) patients had at least one serious adverse event. The most common serious adverse events were hematological disorders (13 [35.14%] of 37 events) and neurological disorders (11 [29.73%] of 37 events). Peripheral neuropathy (P < 0.0001), anemia (P = 0.029), and skin reaction (P = 0.021) occurred more frequently among linezolid interrupters. Conclusions: In conclusion linezolid-based combination therapy, with linezolid at a dose of 600mg daily is associated with satisfactory culture conversion rate by 10 months of therapy. However, linezolid may be associated with peripheral neuropathy that may warrant interruption of the drug.