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April 17, 2026IJTLD OPEN1 citationsOpen Access

Safety of treatment regimens for drug-resistant TB over a 15-year period: a scoping review

MAM. AmiriMCM. CheraghiMNM.J. Nasiri

Key Points

  • The aim is to review safety, quality of life, and unmet needs in drug-resistant TB treatments over the past 15 years.
  • Conducted a scoping review of studies published between 2009 and 2024.
  • Utilized databases such as PubMed/MEDLINE, Embase, Cochrane CENTRAL, and others.
  • Included studies reporting on safety, quality of life, and unmet needs in drug-resistant TB.
  • Identified 57 studies with a total of 9,874 patients.
  • Serious adverse events ranged from 0.2% to 72.4% across different study types.
  • Linezolid was frequently associated with gastrointestinal and haematological adverse events.
  • Adverse events linked to bedaquiline were less common, at 1.7%–2.4%, compared to linezolid's 14.1%–17.2%.
  • Highlighted need for new treatments with better safety profiles.

Abstract

SUMMARY BACKGROUND A previous review summarised the evolution and efficacy of the regimens to treat rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB), underscoring the persistent need for efficacious shorter treatments. The aim of this scoping review was to explore safety, quality of life (QoL), and unmet needs associated with RR/MDR-TB in studies published between 2009 and 2024. METHODS We searched PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus, and Web of Science for studies reporting safety, QoL, and unmet needs in the last 15 years. RESULTS Fifty-seven studies including 9,874 patients were identified, with significant variation in geographic distribution, sample size, and other core variables. The overall proportion of serious adverse events (AEs) ranged between 0.2% and 10.1% in retrospective studies, 1.0%–72.4% in prospective cohorts, and 20.0%–25.0% in experimental studies, with no data on QoL. Almost all studies containing linezolid (LZD) reported gastrointestinal and haematological AEs. In studies based on individual patient data, AEs associated with bedaquiline (1.7%–2.4%) and fluoroquinolones (3%–4%) were less frequent than those associated with LZD (14.1%–17.2%). The World Health Organization 95% credible interval range was 10.1%–27.0%. CONCLUSION While efficacious RR/MDR-TB regimens are recommended, individual drugs still cause AEs potentially leading to decreased adherence. New efficacious treatments with improved safety/tolerability profiles are needed.

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Cite This Study

Amiri et al. (2026) studied this question.

synapsesocial.com/papers/69e1cecc5cdc762e9d857bb9https://doi.org/10.5588/ijtldopen.25.0728
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