Long-term results of treatment with bedaquiline in patients with drug-resistant tuberculosis

The new drug bedaquiline (Bq) is used in the treatment of patients with multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). <b>Aim:</b> to evaluate the outcomes of treatment of patients with MDR and XDR-TB 3 years after a Bq course. <b>Materials and Methods:</b> The study was conducted in the Saratov Region (Russia). 38 patients (24 men, 14 women) received a 6-month Bq course in 2014-2016. All patients had destructive pulmonary TB and they had previous therapy failures. 27 people had MDR-TB, of which 25.9% (7/27) had chronic TB. 11 person had XDR-TB, of which 81.8% (9/11) had chronic TB. We evaluated the condition of patients using x-ray data and sputum cultures on MBT 3 years after. <b>Results:</b> Among patients with MDR-TB, 81.5% (22/27) stopped allocating MBT, and in 59.3% (16/27) cases, cavities were closed or operated on. In the group of XDR-TB patients, 63.3% (7/11) of patients stopped bacterial release, and 18.2% (2/11) of people had their decay cavities closed. The main reasons for treatment failures were chronic TB, undesirable side reactions to other anti-TB drugs, and severe comorbidities. <b>Conclusions:</b> The use of Bq in chemotherapy regimens for TB patients with previous treatment failures is effective and gives stable positive results after 3 years of follow-up in 81.5% of people with MDR-TB and 63.6% of people with XDR-TB (in general 76.3%). These results are better than the average data for treatment of patients with MDR-TB in Russia for the same period of time: 53.5% and 54.7% (2015, 2016).