Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Haley Connie A, Schechter Marcos C, Ashkin David, Peloquin Charles A, Peter Cegielski J, Andrino Barbara B, Burgos Marcos, Caloia Lori A, Chen Lisa, Colon-Semidey Angel, DeSilva Malini B, Dhanireddy Shireesha, Dorman Susan E, Dworkin Felicia F, Hammond-Epstein Heidi, Easton Alice V, Gaensbauer James T, Ghassemieh Bijan, Gomez Maria E, Horne David, Jasuja Supriya, Jones Betsy A, Kaplan Leonard J, Khan Asharaf Edward, Kracen Elizabeth, Labuda Sarah, Landers Karen M, Lardizabal Alfred A, Lasley Maria T, Letzer David M, Lopes Vinicius K, Lubelchek Ronald J, Patricia Macias C, Mihalyov Aimee, Misch Elizabeth Ann, Murray Jason A, Narita Masahiro, Nilsen Diana M, Ninneman Megan J, Ogawa Lynne, Oladele Alawode, Overman Melissa, Ray Susan M, Ritger Kathleen A, Rowlinson Marie-Claire, Sabuwala Nadya, Schiller Thomas M, Schwartz Lawrence E, Spitters Christopher, Thomson Douglas B, Tresgallo Rene Rico, Valois Patrick, Goswami Neela D, BPaL Implementation Group
Аннотация
METHODS: Data from US patients treated with BPaL between 14 October 2019 and 30 April 2022 were compiled and analyzed by the BPaL Implementation Group (BIG), including baseline examination and laboratory, electrocardiographic, and clinical monitoring throughout treatment and follow-up. Linezolid dosing and clinical management was provider driven, and most patients had linezolid adjusted by therapeutic drug monitoring.
RESULTS: Of 70 patients starting BPaL, 2 changed to rifampin-based therapy, 68 (97.1%) completed BPaL, and 2 of the 68 (2.9%) experienced relapse after completion. Using an initial 600-mg linezolid dose daily adjusted by therapeutic drug monitoring and careful clinical and laboratory monitoring for adverse effects, supportive care, and expert consultation throughout BPaL treatment, 3 patients (4.4%) with hematologic toxicity and 4 (5.9%) with neurotoxicity required a change in linezolid dose or frequency. The median BPaL duration was 6 months.
CONCLUSIONS: BPaL has transformed treatment for rifampin-resistant or intolerant tuberculosis. In this cohort, effective treatment required less than half the duration recommended in 2019 US guidelines for drug-resistant tuberculosis. Use of individualized linezolid dosing and monitoring likely enhanced safety and treatment completion. The BIG cohort demonstrates that early implementation of new tuberculosis treatments in the United States is feasible.