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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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

Cite this

Dey, Teesta ; Brigden, Grania ; Cox, Helen Suzanne ; Shubber, Zara ; Cooke, Graham ; Ford, Nathan. / Outcomes of clofazimine for the treatment of drug-resistant tuberculosis: a systematic review and meta-analysis. In: Journal of Antimicrobial Chemotherapy. 2013 ; Vol. 68, No. 2 (Art. No.: dks389). pp. 284 - 293.
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Dey, T, Brigden, G, Cox, HS, Shubber, Z, Cooke, G & Ford, N 2013, 'Outcomes of clofazimine for the treatment of drug-resistant tuberculosis: a systematic review and meta-analysis', Journal of Antimicrobial Chemotherapy, vol. 68, no. 2 (Art. No.: dks389), pp. 284 - 293. https://doi.org/10.1093/jac/dks389

Outcomes of clofazimine for the treatment of drug-resistant tuberculosis: a systematic review and meta-analysis. / Dey, Teesta; Brigden, Grania; Cox, Helen Suzanne; Shubber, Zara; Cooke, Graham; Ford, Nathan.

In: Journal of Antimicrobial Chemotherapy, Vol. 68, No. 2 (Art. No.: dks389), 2013, p. 284 - 293.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Outcomes of clofazimine for the treatment of drug-resistant tuberculosis: a systematic review and meta-analysis

AU - Dey, Teesta

AU - Brigden, Grania

AU - Cox, Helen Suzanne

AU - Shubber, Zara

AU - Cooke, Graham

AU - Ford, Nathan

PY - 2013

Y1 - 2013

N2 - 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.

AB - 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.

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U2 - 10.1093/jac/dks389

DO - 10.1093/jac/dks389

M3 - Article

VL - 68

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JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

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ER -