Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Medical Management of Drug-Resistant Tuberculosis

  • Jeon, Doosoo (Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine)
  • Received : 2015.01.31
  • Accepted : 2015.03.19
  • Published : 2015.04.30
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Abstract

Drug-resistant tuberculosis (TB) is still a major threat worldwide. However, recent scientific advances in diagnostic and therapeutic tools have improved the management of drug-resistant TB. The development of rapid molecular testing methods allows for the early detection of drug resistance and prompt initiation of an appropriate treatment. In addition, there has been growing supportive evidence for shorter treatment regimens in multidrug-resistant TB; and for the first time in over 50 years, new anti-TB drugs have been developed. The World Health Organization has recently revised their guidelines, primarily based on evidence from a meta-analysis of individual patient data (n=9,153) derived from 32 observational studies, and outlined the recommended combination and correct use of available anti-TB drugs. This review summarizes the updated guidelines with a focus on the medical management of drug-resistant TB.

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References

  1. Park YK, Park YS, Na KI, Cho EH, Shin SS, Kim HJ. Increased tuberculosis burden due to demographic transition in Korea from 2001 to 2010. Tuberc Respir Dis 2013;74:104-10. https://doi.org/10.4046/trd.2013.74.3.104
  2. Bai GH, Park YK, Choi YW, Bai JI, Kim HJ, Chang CL, et al. Trend of anti-tuberculosis drug resistance in Korea, 1994-2004. Int J Tuberc Lung Dis 2007;11:571-6.
  3. Park YS, Hong SJ, Boo YK, Hwang ES, Kim HJ, Cho SH, et al. The national status of tuberculosis using nationwide medical records survey of patients with tuberculosis in Korea. Tuberc Respir Dis 2012;73:48-55. https://doi.org/10.4046/trd.2012.73.1.48
  4. Johnston JC, Shahidi NC, Sadatsafavi M, Fitzgerald JM. Treatment outcomes of multidrug-resistant tuberculosis: a systematic review and meta-analysis. PLoS One 2009;4:e6914. https://doi.org/10.1371/journal.pone.0006914
  5. Orenstein EW, Basu S, Shah NS, Andrews JR, Friedland GH, Moll AP, et al. Treatment outcomes among patients with multidrug-resistant tuberculosis: systematic review and metaanalysis. Lancet Infect Dis 2009;9:153-61. https://doi.org/10.1016/S1473-3099(09)70041-6
  6. Kim HJ, Hong YP, Kim SJ, Lew WJ, Lee EG. Ambulatory treatment of multidrug-resistant pulmonary tuberculosis patients at a chest clinic. Int J Tuberc Lung Dis 2001;5:1129-36.
  7. Park SK, Lee WC, Lee DH, Mitnick CD, Han L, Seung KJ. Selfadministered, standardized regimens for multidrug-resistant tuberculosis in South Korea. Int J Tuberc Lung Dis 2004;8:361-8.
  8. Kim HR, Hwang SS, Kim HJ, Lee SM, Yoo CG, Kim YW, et al. Impact of extensive drug resistance on treatment outcomes in non-HIV-infected patients with multidrug-resistant tuberculosis. Clin Infect Dis 2007;45:1290-5. https://doi.org/10.1086/522537
  9. Kwon YS, Kim YH, Suh GY, Chung MP, Kim H, Kwon OJ, et al. Treatment outcomes for HIV-uninfected patients with multidrug-resistant and extensively drug-resistant tuberculosis. Clin Infect Dis 2008;47:496-502. https://doi.org/10.1086/590005
  10. Kim DH, Kim HJ, Park SK, Kong SJ, Kim YS, Kim TH, et al. Treatment outcomes and long-term survival in patients with extensively drug-resistant tuberculosis. Am J Respir Crit Care Med 2008;178:1075-82. https://doi.org/10.1164/rccm.200801-132OC
  11. Park JK, Koh WJ, Kim DK, Kim EK, Kim YI, Kim HJ, et al. Treatment outcomes and prognostic factors in patients with multidrug-resistant tuberculosis in Korean private hospitals. Tuberc Respir Dis 2010;69:95-102. https://doi.org/10.4046/trd.2010.69.2.95
  12. Jeon DS, Shin DO, Park SK, Seo JE, Seo HS, Cho YS, et al. Treatment outcome and mortality among patients with multidrug-resistant tuberculosis in tuberculosis hospitals of the public sector. J Korean Med Sci 2011;26:33-41. https://doi.org/10.3346/jkms.2011.26.1.33
  13. World Health Organization. Guidelines for the programmatic management of drug-resistant tuberculosis: 2011 update. Geneva: World Health Organization; 2011.
  14. World Health Organization. Companion handbook to the WHO guidelines for the programmatic management of drugresistant tuberculosis. Geneva: World Health Organization; 2014.
  15. Ahuja SD, Ashkin D, Avendano M, Banerjee R, Bauer M, Bayona JN, et al. Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients. PLoS Med 2012;9:e1001300. https://doi.org/10.1371/journal.pmed.1001300
  16. Joint Committee for the Revision of Korean Guidelines for Tuberculosis, Korean Centers for Disease Control and Prevention. Korean guidelines for tuberculosis. 2nd ed. Seoul and Cheongwon: Joint Committee for the Revision of Korean Guidelines for Tuberculosis, Korean Centers for Disease Control and Prevention; 2014.
  17. Minion J, Leung E, Menzies D, Pai M. Microscopic-observation drug susceptibility and thin layer agar assays for the detection of drug resistant tuberculosis: a systematic review and meta-analysis. Lancet Infect Dis 2010;10:688-98. https://doi.org/10.1016/S1473-3099(10)70165-1
  18. World Health Organization. Policy statement. Molecular line probe assay for rapid screening of patients at risk of multidrug-resistant tuberculosis (MDR-TB). Geneva: World Health Organization; 2008.
  19. World Health Organization. Policy statement. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF system. Geneva: World Health Organization; 2011.
  20. Bang H, Park S, Hwang J, Jin H, Cho E, Kim DY, et al. Improved rapid molecular diagnosis of multidrug-resistant tuberculosis using a new reverse hybridization assay, REBA MTB-MDR. J Med Microbiol 2011;60:1447-54. https://doi.org/10.1099/jmm.0.032292-0
  21. Cho E, Shamputa IC, Kwak HK, Lee J, Lee M, Hwang S, et al. Utility of the REBA MTB-Rifa(R) assay for rapid detection of rifampicin resistant Mycobacterium tuberculosis. BMC Infect Dis 2013;13:478. https://doi.org/10.1186/1471-2334-13-478
  22. Moon HW, Hur M, Kim JY, Yun YM. Comparison of three molecular assays for the detection of rifampin resistance in Mycobacterium tuberculosis . J Clin Lab Anal 2015;29:142-5. https://doi.org/10.1002/jcla.21742
  23. World Health Organization. Definitions and reporting framework for tuberculosis: 2013 revision. Geneva: World Health Organization; 2013.
  24. Calligaro GL, Moodley L, Symons G, Dheda K. The medical and surgical treatment of drug-resistant tuberculosis. J Thorac Dis 2014;6:186-95.
  25. Migliori GB, Sotgiu G, Gandhi NR, Falzon D, DeRiemer K, Centis R, et al. Drug resistance beyond extensively drugresistant tuberculosis: individual patient data meta-analysis. Eur Respir J 2013;42:169-79. https://doi.org/10.1183/09031936.00136312
  26. Weyer K, Mirzayev F, Migliori GB, Van Gemert W, D'Ambrosio L, Zignol M, et al. Rapid molecular TB diagnosis: evidence, policy making and global implementation of Xpert MTB/RIF. Eur Respir J 2013;42:252-71. https://doi.org/10.1183/09031936.00157212
  27. Arentz M, Sorensen B, Horne DJ, Walson JL. Systematic review of the performance of rapid rifampicin resistance testing for drug-resistant tuberculosis. PLoS One 2013;8:e76533. https://doi.org/10.1371/journal.pone.0076533
  28. Lange C, Abubakar I, Alffenaar JW, Bothamley G, Caminero JA, Carvalho AC, et al. Management of patients with multidrug-resistant/extensively drug-resistant tuberculosis in Europe: a TBNET consensus statement. Eur Respir J 2014;44:23-63. https://doi.org/10.1183/09031936.00188313
  29. Partners In Health. The PIH guide to the medical management of multidrug-resistant tuberculosis. 2nd ed. Boston: Partners In Health; 2014.
  30. World Health Organization. Guidelines for the programmatic management of drug-resistant tuberculosis. Geneva: World Health Organization; 2006.
  31. World Health Organization. Guidelines for the programmatic management of drug-resistant tuberculosis: emergency update 2008. Geneva: World Health Organization; 2008.
  32. Mitnick CD, Franke MF, Rich ML, Alcantara Viru FA, Appleton SC, Atwood SS, et al. Aggressive regimens for multidrugresistant tuberculosis decrease all-cause mortality. PLoS One 2013;8:e58664. https://doi.org/10.1371/journal.pone.0058664
  33. Franke MF, Appleton SC, Mitnick CD, Furin JJ, Bayona J, Chalco K, et al. Aggressive regimens for multidrug-resistant tuberculosis reduce recurrence. Clin Infect Dis 2013;56:770-6. https://doi.org/10.1093/cid/cis1008
  34. Velasquez GE, Becerra MC, Gelmanova IY, Pasechnikov AD, Yedilbayev A, Shin SS, et al. Improving outcomes for multidrug-resistant tuberculosis: aggressive regimens prevent treatment failure and death. Clin Infect Dis 2014;59:9-15. https://doi.org/10.1093/cid/ciu209
  35. Blumberg HM, Burman WJ, Chaisson RE, Daley CL, Etkind SC, Friedman LN, et al. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 2003;167:603-62. https://doi.org/10.1164/rccm.167.4.603
  36. World Health Organization. Treatment of tuberculosis: guidelines for national programmes. 2nd ed. Geneva: World Health Organization; 1997.
  37. Van Deun A, Maug AK, Salim MA, Das PK, Sarker MR, Daru P, et al. Short, highly effective, and inexpensive standardized treatment of multidrug-resistant tuberculosis. Am J Respir Crit Care Med 2010;182:684-92. https://doi.org/10.1164/rccm.201001-0077OC
  38. Nunn AJ, Rusen ID, Van Deun A, Torrea G, Phillips PP, Chiang CY, et al. Evaluation of a standardized treatment regimen of anti-tuberculosis drugs for patients with multi-drug-resistant tuberculosis (STREAM): study protocol for a randomized controlled trial. Trials 2014;15:353. https://doi.org/10.1186/1745-6215-15-353
  39. Diacon AH, Pym A, Grobusch M, Patientia R, Rustomjee R, Page-Shipp L, et al. The diarylquinoline TMC207 for multidrug-resistant tuberculosis. N Engl J Med 2009;360:2397-405. https://doi.org/10.1056/NEJMoa0808427
  40. Gler MT, Skripconoka V, Sanchez-Garavito E, Xiao H, Cabrera-Rivero JL, Vargas-Vasquez DE, et al. Delamanid for multidrug-resistant pulmonary tuberculosis. N Engl J Med 2012;366:2151-60. https://doi.org/10.1056/NEJMoa1112433
  41. Franke MF, Becerra MC, Tierney DB, Rich ML, Bonilla C, Bayona J, et al. Counting pyrazinamide in regimens for multidrug-resistant tuberculosis. Ann Am Thorac Soc 2015;12:674-9. https://doi.org/10.1513/AnnalsATS.201411-538OC
  42. Caminero JA, Sotgiu G, Zumla A, Migliori GB. Best drug treatment for multidrug-resistant and extensively drug-resistant tuberculosis. Lancet Infect Dis 2010;10:621-9. https://doi.org/10.1016/S1473-3099(10)70139-0
  43. Koh WJ, Lee SH, Kang YA, Lee CH, Choi JC, Lee JH, et al. Comparison of levofloxacin versus moxifloxacin for multidrugresistant tuberculosis. Am J Respir Crit Care Med 2013;188:858-64. https://doi.org/10.1164/rccm.201303-0604OC
  44. Larsen MH, Vilcheze C, Kremer L, Besra GS, Parsons L, Salfinger M, et al. Overexpression of inhA, but not kasA, confers resistance to isoniazid and ethionamide in Mycobacterium smegmatis, M. bovis BCG and M. tuberculosis . Mol Microbiol 2002;46:453-66. https://doi.org/10.1046/j.1365-2958.2002.03162.x
  45. Chang KC, Yew WW, Tam CM, Leung CC. WHO group 5 drugs and difficult multidrug-resistant tuberculosis: a systematic review with cohort analysis and meta-analysis. Antimicrob Agents Chemother 2013;57:4097-104. https://doi.org/10.1128/AAC.00120-13
  46. Tang S, Yao L, Hao X, Liu Y, Zeng L, Liu G, et al. Clofazimine for the treatment of multidrug-resistant tuberculosis: prospective, multicenter, randomized controlled study in china. Clin Infect Dis 2015;60:1361-7.
  47. Bastos ML, Hussain H, Weyer K, Garcia-Garcia L, Leimane V, Leung CC, et al. Treatment outcomes of patients with multidrug-resistant and extensively drug-resistant tuberculosis according to drug susceptibility testing to first- and second-line drugs: an individual patient data meta-analysis. Clin Infect Dis 2014;59:1364-74. https://doi.org/10.1093/cid/ciu619
  48. Falzon D, Gandhi N, Migliori GB, Sotgiu G, Cox HS, Holtz TH, et al. Resistance to fluoroquinolones and second-line injectable drugs: impact on multidrug-resistant TB outcomes. Eur Respir J 2013;42:156-68. https://doi.org/10.1183/09031936.00134712
  49. Jacobson KR, Tierney DB, Jeon CY, Mitnick CD, Murray MB. Treatment outcomes among patients with extensively drugresistant tuberculosis: systematic review and meta-analysis. Clin Infect Dis 2010;51:6-14. https://doi.org/10.1086/653115
  50. Lee M, Lee J, Carroll MW, Choi H, Min S, Song T, et al. Linezolid for treatment of chronic extensively drug-resistant tuberculosis. N Engl J Med 2012;367:1508-18. https://doi.org/10.1056/NEJMoa1201964
  51. Tang S, Yao L, Hao X, Zhang X, Liu G, Liu X, et al. Efficacy, safety and tolerability of linezolid for the treatment of XDRTB: a study in China. Eur Respir J 2015;45:161-70. https://doi.org/10.1183/09031936.00035114
  52. Diacon AH, Pym A, Grobusch MP, de los Rios JM, Gotuzzo E, Vasilyeva I, et al. Multidrug-resistant tuberculosis and culture conversion with bedaquiline. N Engl J Med 2014;371:723-32. https://doi.org/10.1056/NEJMoa1313865
  53. Guglielmetti L, Le Du D, Jachym M, Henry B, Martin D, Caumes E, et al. Compassionate use of bedaquiline for the treatment of multidrug-resistant and extensively drug-resistant tuberculosis: interim analysis of a French cohort. Clin Infect Dis 2015;60:188-94. https://doi.org/10.1093/cid/ciu786
  54. Skripconoka V, Danilovits M, Pehme L, Tomson T, Skenders G, Kummik T, et al. Delamanid improves outcomes and reduces mortality in multidrug-resistant tuberculosis. Eur Respir J 2013;41:1393-400. https://doi.org/10.1183/09031936.00125812
  55. Diacon AH, Dawson R, von Groote-Bidlingmaier F, Symons G, Venter A, Donald PR, et al. 14-day bactericidal activity of PA-824, bedaquiline, pyrazinamide, and moxifloxacin combinations: a randomised trial. Lancet 2012;380:986-93. https://doi.org/10.1016/S0140-6736(12)61080-0

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