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Registration Number

0225U000341, (0122U000554) , R & D reports

Title

To improve of antimycobacterial therapy with using new modified short-term treatment regimens in patients with chemoresistant pulmonary tuberculosis

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Удосконалити антимікобактеріальну терапію із використанням нових модифікованих короткострокових режимів лікування у хворих на лікарсько-стійкий туберкульоз легень

Head

Lytvynenko Nataliia A., Доктор медичних наук

Registration Date

09-01-2025

Organization

State organization "National scientific center of phthisiatry, pulmonology and allergology named after F. G. Yanovskyi National academy of medical sciences of Ukraine"

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Тo determine the optimal algorithms for sorting of patients to select the optimal new modified short-term regimens of antimycobacterial therapy in patients what chemoresistant pulmonary tuberculosis, what will let to increase the effectiveness of treatment and save public funds

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 Object – 1068 patients with MDR TB. Aim – to determine the optimal patient triage algorithms for the selection of optimal new modified short-term regimens of antimycobacterial therapy in patients with drug-resistant pulmonary tuberculosis (TB), which will increase the effectiveness of treatment and save public funds. Methods – clinical, radiological, laboratory, microbiological. It was established that the effectiveness of treatment of various 6-9 months of modified short-term regimens (mSTR) for patients with multidrug-resistant TB (MDR-TB) and with pre-extensive drug resistance (pre-MDR-TB) is high – 88,1-95,3 %. In the remote period, repeated episodes of TB have not been established. The tolerability and safety of various mSTR have been studied. Among the 9-month regimes, the best tolerability is in mSTR-2 with moxifloxacin (Mfx) – adverse events (AE) 27,9 %; among 6 months in mSTR-7 (BPaLM) – 16,7 %. The tolerability and safety of various mSTR for patients with extensively drug-resistant TB (MDR-TB) were studied. It was found that mSTR-6 based on delamanid is better tolerated –11,8 % of AE. The cost-effectiveness was calculated and the optimal mSTR was determined. Among 9-month mSTR for MDR-TB, the best indicator is in mSTR-2 based on Mfx, among 6-month for XDR-TB – mSTR-7, among 6-month for pre-XDR-TB – mSTR-5. The technology of optimal use of the BPaL was developed, which made it possible to achieve the effectiveness of treatment of patients with pre-XDR-TB – 91,5 %. The algorithm for determining the optimal mSTR was developed: аmong the 9-month regimes for MDR-TB, the priority is mSTR-2, only in case of impossibility of its appointment, mSTR-1 is used. Among the 6-month regimes, the priority is mSTR-7 for MDR-TB and mSTR-5 for pre-XDR-TB. In case of intolerance, mSTR-4 or mSTR-6 are prescribed. An algorithm for providing individual psychological support to patients receiving treatment for mSTR has been developed. Sphere of application – tuberculosis.

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Barbova Anna I.
Veselovskyi Leonid V.
Hritsova Nataliia A.
Davydenko Valentyna V.
Zhurylo Oleksandr A.
Zaikov Serhii V.
Korotchenko Svitlana P.
Lafeta Anastasiia S.
Lytvynenko Nataliia A.
Liubevych Rostyslav L.
Pyroh Alla I.
Pohrebna Maryna V.
Polinovska Lesia V.
Protsyk Liubomyr M.
Siomak Olha V.
Senko Yuliia O.
Tsapyk Oksana O.
Chobotar Oksana P.
Shcherbakova Lesia V.
Yalenko Viktoriia M.

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2025-01-09