APHP, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, F-75013 Paris, France.
Sorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, équipe 2, F-75013, Paris, France.
Future Microbiol. 2020 Jun;15:779-799. doi: 10.2217/fmb-2019-0309. Epub 2020 Jul 23.
Drug-resistant tuberculosis (TB) represents a substantial threat to the global efforts to control this disease. After decades of stagnation, the treatment of drug-resistant TB is undergoing major changes: two drugs with a new mechanism of action, bedaquiline and delamanid, have been approved by stringent regulatory authorities and are recommended by the WHO. This narrative review summarizes the evidence, originating from both observational studies and clinical trials, which is available to support the use of these drugs, with a focus on special populations. Areas of uncertainty, including the use of the two drugs together or for prolonged duration, are discussed. Ongoing clinical trials are aiming to optimize the use of bedaquiline and delamanid to shorten the treatment of drug-resistant TB.
耐多药结核病(TB)对全球结核病控制工作构成了重大威胁。经过几十年的停滞不前,耐多药结核病的治疗正在发生重大变化:两种具有新作用机制的药物——贝达喹啉和德拉马尼——已经通过了严格的监管机构的批准,并被世界卫生组织推荐使用。本文综述了来自观察性研究和临床试验的证据,这些证据支持了这些药物的使用,重点关注特殊人群。讨论了一些不确定的领域,包括两种药物的联合使用或长期使用。正在进行的临床试验旨在优化贝达喹啉和德拉马尼的使用,以缩短耐多药结核病的治疗时间。