Outcomes of clofazimine for the treatment of drug-resistant tuberculosis: a systematic review and meta-analysis

Teesta Dey, Grania Brigden, Helen Suzanne Cox, Zara Shubber, Graham Cooke, Nathan Ford

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94 Citations (Scopus)

Abstract

Background: Current anti-tuberculosis therapeutics are not sufficiently effective against drug-resistant tuberculosis (DR-TB), and there is a need for new drugs and therapeutic approaches. It has been proposed that repurposing clofazimine for DR-TB treatment might be one way to increase therapeutic options. Methods: We conducted a systematic review of studies reporting on the efficacy and safety of clofazimine as part of combination therapy for DR-TB. Six databases and six conference abstract sites were searched from inception until April 2012. All studies involving the use of clofazimine in the treatment of DR-TB were included. Results: Twelve studies, comprising 3489 patients across 10 countries, were included in this review. Treatment success ranged from 16.5 (95 CI 2.7 -38.7 ) to 87.8 (95 CI 76.8 -95.6 ), with an overall pooled proportion of 61.96 achieving treatment success (95 CI 52.79 -71.12 ) (t 2 0.07). Mortality, treatment interruptions, defaulting and adverse events were all in line with DR-TB treatment outcomes overall. The most commonly reported adverse events were gastrointestinal disturbances and skin pigmentation. Conclusions: The available evidence to date suggests that clofazimine could be considered as an additional therapeutic option in the treatment of DR-TB. The optimal dose of clofazimine and duration of use require further investigation. ? The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Original languageEnglish
Pages (from-to)284 - 293
Number of pages10
JournalJournal of Antimicrobial Chemotherapy
Volume68
Issue number2 (Art. No.: dks389)
DOIs
Publication statusPublished - 2013

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