Delamanid-based regimens work against multidrug-resistant tuberculosis

The use of delamanid-containing regimens is safe and effective in the management of multidrug-resistant tuberculosis (MDR-TB), with high culture conversion and treatment success rates despite extensive resistance patterns, according to the results of a meta-analysis.

Researchers conducted a systematic review and searched multiple online databases for studies evaluating the efficacy of treatment regimens that contained delamanid in patients with MDR-TB. Out of the 351 references screened, 25 met the inclusion criteria (22 observational and three experimental) and were included in the meta-analysis.

The total study population comprised 591 patients in the delamanid-containing regimen group and 685 patients in the delamanid/bedaquiline-containing regimen group, in observation. The mean age overall was 36.1 years, and the study period ranged from 2012 to 2021.

Pooled data from observational studies showed that the overall treatment success rates were 80.9 percent (95 percent confidence interval [CI], 72.6–87.2) on delamanid-containing regimens and 75.2 percent (95 percent CI, 68.1–81.1) on delamanid and bedaquiline-containing regimens. There was no evidence of publication bias (Begg's test: p>0.05 for both).

Meanwhile, pooled data from experimental studies revealed a treatment success rate of 72.5 percent (95 percent CI, 44.2–89.8; p<0.001, I², 95.1 percent) with delamanid-containing regimens. There was with no evidence of publication bias (Begg's test; p>0.05).

In the DLM-containing regimens group, only four (2.4 percent) patients had QTcF prolongation attributed to treatment. Meanwhile, two patients (1.5 percent) had gastrointestinal symptoms and one (3.7 percent) had dermatologic symptoms.