Delamanid-containing regimens and multidrug-resistant tuberculosis

Background and Aim : Multidrug-resistant tuberculosis (MDR-TB) is a life-threateningcondition needing long poly-chemotherapy regimens. As no systematic reviews/meta-analysis isavailable to comprehensively evaluate the role of delamanid (DLM), we evaluated its effectivenessand safety.Methods : We reviewed the relevant scientific literature published up to January ۲۰, ۲۰۲۲. Thepooled success treatment rate with ۹۵% confidence intervals (CI) was assessed using a randomeffectmodel. We assessed studies for quality and bias, and considered P<۰.۰۵ to be statisticallysignificant.Results : After reviewing ۶۲۶ records, we identified ۲۵ studies that met the inclusion criteria, ۲۲observational and ۳ experimental, with ۱۲۷۶ and ۴۱۱ patients, respectively. In observationalstudies the overall pooled treatment success rate of DLM-containing regimens was ۸۰.۹% (۹۵%CI ۷۲.۶-۸۷.۲) with no evidence of publication bias (Begg's test; P >۰.۰۵). The overall pooledtreatment success rate in DLM and bedaquiline-containing regimens was ۷۵.۲% (۹۵% CI ۶۸.۱-۸۱.۱) with no evidence of publication bias (Begg's test; P >۰.۰۵). In experimental studies thepooled treatment success rate of DLM-containing regimens was ۷۲.۵ (۹۵% CI ۴۴.۲-۸۹.۸, P <۰.۰۰۱,I۲: ۹۵.۱%) with no evidence of publication bias (Begg's test; P >۰.۰۵).Conclusion : In MDR-TB patients receiving DLM, culture conversion and treatment success rateswere high despite extensive resistance with limited adverse events.