@article{fdi:010074011,
  title = {{T}reatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis : an individual patient data meta-analysis},
  author = {{A}hmad, {N}. and {A}huja, {S}. {D}. and {A}kkerman, {O}. {W}. and {A}lffenaar, {J}. {W}. {C}. and {A}nderson, {L}. {F}. and {B}aghaei, {P}. and {B}ang, {D}. and {B}arry, {P}. {M}. and {B}astos, {M}. {L}. and {B}ehera, {D}. and {B}enedetti, {A}. and {B}isson, {G}. {P}. and {B}oeree, {M}. {J}. and {B}onnet, {M}aryline and {B}rode, {S}. {K}. and {B}rust, {J}. {C}. {M}. and {C}ai, {Y}. and {C}aumes, {E}. and {C}egielski, {J}. {P}. and {C}entis, {R}. and {C}han, {P}. {C}. and {C}han, {E}. {D}. and {C}hang, {K}. {C}. and {C}harles, {M}. and {C}irule, {A}. and {D}alcolmo, {M}. {P}. and {D}'{A}mbrosio, {L}. and de {V}ries, {G}. and {D}heda, {K}. and {E}smail, {A}. and {F}lood, {J}. and {F}ox, {G}. {J}. and {F}rechet-{J}achym, {M}. and {F}regona, {G}. and {G}ayoso, {R}. and {G}egia, {M}. and {G}ler, {M}. {T}. and {G}u, {S}. and {G}uglielmetti, {L}. and {H}oltz, {T}. {H}. and {H}ughes, {J}. and {I}saakidis, {P}. and {J}arlsberg, {L}. and {K}empker, {R}. {R}. and {K}eshavjee, {S}. and {K}han, {F}. {A}. and {K}ipiani, {M}. and {K}oenig, {S}. {P}. and {K}oh, {W}. {J}. and {K}ritski, {A}. and {K}uksa, {L}. and {K}vasnovsky, {C}. {L}. and {K}wak, {N}. and {L}an, {Z}. {Y}. and {L}ange, {C}. and {L}aniado-{L}aborin, {R}. and {L}ee, {M}. and {L}eimane, {V}. and {L}eung, {C}. {C}. and {L}eung, {E}. {C}. {C}. and {L}i, {P}. {Z}. and {L}owenthal, {P}. and {M}aciel, {E}. {L}. and {M}arks, {S}. {M}. and {M}ase, {S}. and {M}buagbaw, {L}. and {M}igliori, {G}. {B}. and {M}ilanov, {V}. and {M}iller, {A}. {C}. and {M}itnick, {C}. {D}. and {M}odongo, {C}. and {M}ohr, {E}. and {M}onedero, {I}. and {N}ahid, {P}. and {N}djeka, {N}. and {O}'{D}onnell, {M}. {R}. and {P}adayatchi, {N}. and {P}almero, {D}. and {P}ape, {J}. {W}. and {P}odewils, {L}. {J}. and {R}eynolds, {I}. and {R}iekstina, {V}. and {R}obert, {J}. and {R}odriguez, {M}. and {S}eaworth, {B}. and {S}eung, {K}. {J}. and {S}chnippel, {K}. and {S}him, {T}. {S}. and {S}ingla, {R}. and {S}mith, {S}. {E}. and {S}otgiu, {G}. and {S}ukhbaatar, {G}. and {T}abarsi, {P}. and {T}iberi, {S}. and {T}rajman, {A}. and {T}rieu, {L}. and {U}dwadia, {Z}. {F}. and van der {W}erf, {T}. {S}. and {V}eziris, {N}. and {V}iiklepp, {P}. and {V}ilbrun, {S}. {C}. and {W}alsh, {K}. and {W}estenhouse, {J}. and {Y}ew, {W}. {W}. and {Y}im, {J}. {J}. and {Z}etola, {N}. {M}. and {Z}ignol, {M}. and {M}enzies, {D}. and {C}ollaborative {G}roup {M}eta-{A}nalysis of {I}ndividual {P}atient {D}ata in {MDR}-{TB} treatment–2017},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {T}reatment outcomes for multidrug-resistant tuberculosis remain poor. {W}e aimed to estimate the association of treatment success and death with the use of individual drugs, and the optimal number and duration of treatment with those drugs in patients with multidrug-resistant tuberculosis. {M}ethods {I}n this individual patient data meta-analysis, we searched {MEDLINE}, {E}mbase, and the {C}ochrane {L}ibrary to identify potentially eligible observational and experimental studies published between {J}an 1, 2009, and {A}pril 30, 2016. {W}e also searched reference lists from all systematic reviews of treatment of multidrug-resistant tuberculosis published since 2009. {T}o be eligible, studies had to report original results, with end of treatment outcomes (treatment completion [success], failure, or relapse) in cohorts of at least 25 adults (aged >18 years). {W}e used anonymised individual patient data from eligible studies, provided by study investigators, regarding clinical characteristics, treatment, and outcomes. {U}sing propensity score-matched generalised mixed effects logistic, or linear regression, we calculated adjusted odds ratios and adjusted risk differences for success or death during treatment, for specific drugs currently used to treat multidrug-resistant tuberculosis, as well as the number of drugs used and treatment duration. {F}indings {O}f 12030 patients from 25 countries in 50 studies, 7346 (61%) had treatment success, 1017 (8%) had failure or relapse, and 1729 (14%) died. {C}ompared with failure or relapse, treatment success was positively associated with the use of linezolid (adjusted risk difference 0.15, 95% {CI} 0.11 to 0.18), levofloxacin (0.15, 0.13 to 0.18), carbapenems (0.14,0.06 to 0.21), moxifloxacin (0.11, 0.08 to 0.14), bedaquiline (0.10, 0.05 to 0.14), and clofazimine (0.06, 0.01 to 0.10). {T}here was a significant association between reduced mortality and use of linezolid (-0.20, -0.23 to -0.16), levofloxacin (-0.06, -0.09 to -0.04), moxifloxacin (-0.07, -0.10 to -0.04), or bedaquiline (-0.14, -0.19 to -0.10). {C}ompared with regimens without any injectable drug, amikacin provided modest benefits, but kanamycin and capreomycin were associated with worse outcomes. {T}he remaining drugs were associated with slight or no improvements in outcomes. {T}reatment outcomes were significantly worse for most drugs if they were used despite in-vitro resistance. {T}he optimal number of effective drugs seemed to be five in the initial phase, and four in the continuation phase. {I}n these adjusted analyses, heterogeneity, based on a simulated {I}-2 method, was high for approximately half the estimates for specific drugs, although relatively low for number of drugs and durations analyses. {I}nterpretation {A}lthough inferences are limited by the observational nature of these data, treatment outcomes were significantly better with use of linezolid, later generation fluoroquinolones, bedaquiline, clofazimine, and carbapenems for treatment of multidrug-resistant tuberculosis. {T}hese findings emphasise the need for trials to ascertain the optimal combination and duration of these drugs for treatment of this condition.},
  keywords = {},
  booktitle = {},
  journal = {{L}ancet},
  volume = {392},
  numero = {10150},
  pages = {821--834},
  ISSN = {0140-6736},
  year = {2018},
  URL = {https://www.documentation.ird.fr/hor/fdi:010074011},
}