Definitive outcomes in patients with rifampicin-resistant tuberculosis treated in Niger from 2012 to 2019: a retrospective cohort study

Mahamadou Bassirou Souleymane, Tom Decroo, Saïdou Mamadou, Alphazazi Soumana, Ibrahim Mamane Lawan, Assiatou Gagara-Issoufou, Eric Adehossi, Nimer Ortuño-Gutiérrez, Lutgarde Lynen, Leen Rigouts, Bouke Catherine de Jong, Armand Van Deun, Alberto Piubello

Research output: Contribution to journalA1: Web of Science-article

Abstract

BACKGROUND: Outcomes of retreatment for rifampicin-resistant tuberculosis (RR-TB) are rarely reported. We report 'definitive outcomes' after a cascade approach to RR-TB treatment. After a bacteriologically adverse outcome for the 9-months fluoroquinolone-based Short Treatment Regimen (STR), patients were retreated with a bedaquiline-based regimen (BDQ-regimen).

METHODS: A Retrospective cohort study of RR-TB patients treated with the STR during 2012-2019 and retreated with a BDQ-regimen in case of failure or relapse was conducted. Definitive relapse-free cure took into account BDQ-regimen outcomes.

RESULTS: Of 367 patients treated with the STR, 20 (5.4%) experienced failure or relapse. Out of these 20 patients, 14 started a BDQ-regimen, of whom none experienced failure or relapse. Definitive end of treatment outcomes of STR after revising with third-line BDQ-regimen outcomes, 84.7% (311/367) were cured relapse-free, 10.6% (39/367) died during treatment and 3.0% (11/367) were lost to follow-up during treatment with either the STR or BDQ-regimen. Six patients (1.6%; 6/367) with STR failure/relapse died before starting a BDQ-regimen. No patient had definitive treatment failure or relapse and remained without treatment.

CONCLUSIONS: If fluoroquinolone resistance is excluded or rare, it is beneficial to use fluoroquinolone as the core drug for a first RR-TB treatment regimen and to safeguard bedaquiline for those in need of retreatment.

Original languageEnglish
JournalInternational Health
ISSN1876-3413
DOIs
Publication statusE-pub ahead of print - 2022

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