BACKGROUNDTo compare the effectiveness, cost, and safety of four regimens recommended by the World Health Organization (WHO) for rifampicin resistance/multidrug-resistance tuberculosis (RR/MDR-TB) Treatment in Eastern China.METHODSWe performed a cohort study among patients with RR/MDR between 2020 and 2022 in Jiangsu Province. The treatment success rate, cost, and drug adverse reaction rate were compared.RESULTSBetween 2020 and 2022, 253 RR/MDR-TB patients were enrolled in the study. 37 (14.62%), 76 (30.04%), 74 (29.25%), and 66 (26.09%) patients had the short-term regimens, the new long-term oral regimens, the new long-term injectable regimens, and the traditional long-term regimens, respectively. The treatment success rate was the highest among patients treated with the short-term regimen (75.68%) and was the lowest among patients treated with the traditional long-term regimens (60.61%). The estimated mean cost per favorable outcome was 142.61 thousand Chinese Yuan (CNY), and the short-term regimens showed the lowest cost in the four regimes (88.51 thousand CNY vs. 174.24 thousand CNY, 144.00 thousand CNY, and 134.98 thousand CNY). Incremental cost-effectiveness ratios of the short-term regimens, the new long-term oral regimen, and the new long-term injectable regimens were -3083.04, 6040.09, and 819.68 CNY compared to the traditional long-term regimens.CONCLUSIONSFor RR/MDR-TB patients in China who meet the criteria for short-term regimens, the short-term regimens were proven to be the most cost-effective of the four regimens recommended by WHO. For RR/MDR-TB patients in China who don't meet the criteria for short-term regimens, the new long-term injectable regimens are more cost-effective than the remaining two regimens.

01 Nov 2024·International Journal of Dental Hygiene

Cross‐angled versus flat‐trim bristle tuft configurations in manual toothbrushes: A systematic review

Review

Author: Sälzer, Sonja ; Slot, Dagmar E. ; Van der Weijden, Fridus A. ; Thomassen, Tim M. J. A.

AbstractAimThis systematic review synthesizes and evaluates the literature regarding the effect of manual toothbrushes (MTBs) with cross‐angled bristle tufts (CA‐TB) compared to flat‐trim (FT‐TB) configurations on plaque scores and parameters of gingival health in adult patients.Materials and MethodsPubMed‐MEDLINE and Cochrane‐CENTRAL databases were searched, from their insertion up to August 1st, 2023, to detect appropriate papers. Clinical trials involving adult patients without periodontitis who performed self‐brushing were eligible for inclusion. Primary outcome parameters included plaque, bleeding, and gingival scores. Secondary outcomes encompassed signs of soft and hard tissue abnormalities. A descriptive analysis was conducted. When feasible, a meta‐analysis was performed using either the ‘fixed’ or ‘random effects’ model, as appropriate.ResultsNine eligible papers were retrieved, presenting 20 comparisons. There was considerable heterogeneity in the clinical and methodological design aspects of the included studies. In the descriptive analysis, eight out of 12 comparisons demonstrated a difference in plaque removal performance in favour of the CA‐TB. However, data regarding bleeding and gingival index scores were inconclusive. A meta‐analysis was performed on plaque, bleeding, and gingival index scores, including different indices used for scoring. The meta‐analysis of short‐term studies showed a medium effect statistically significant difference in the reduction of plaque scores in favour of the CA‐TB (SMD = 0.75; 95% CI (0.51; 0.99)), but this was not substantiated in longer‐term studies (SMD = −0.06; 95% CI(−0.44; 0.31)). No adverse events were described in any group.ConclusionWithin the limitations of the present study design, short‐term evaluations, as assessed with various plaque indices, show a weak certainty in favour of the cross‐angled toothbrush over the flat‐trim toothbrush. However, based on longer‐term evaluations, there is insufficient support due to the inconsistent outcomes of the analysis.

01 Nov 2023·JAIDS Journal of Acquired Immune Deficiency Syndromes

Successful Multidrug-Resistant Tuberculosis Treatment Without HIV Viral Suppression: A Missed Opportunity

Article

Author: Patil, Amita ; Ngozo, Jacqueline ; Dooley, Kelly E. ; Geiger, Keri ; Ndjeka, Norbert ; Budhathoki, Chakra ; Farley, Jason E. ; Lowensen, Kelly

Background:Coinfection with multidrug-resistant tuberculosis (MDR-TB) and HIV is common, but few published studies examine how undergoing MDR-TB treatment affects HIV disease indicators.Methods:Using data from a nested, retrospective cohort of people with HIV (PWH) and successful MDR-TB treatment outcomes, we built multivariable regression models to explore correlates of HIV viral suppression at MDR-TB treatment completion.Results:Among 531 PWH successfully treated for MDR-TB, mean age was 37.4 years (SD 10.2, interquartile range 30–43), 270 (50.8%) were male, 395 (74.4%) were virally suppressed at MDR-TB outcome, and 259 (48.8%) took bedaquiline. Older age (adjusted odds ratio [aOR] 1.04, 95% confidence interval [CI]: 1.01 to 1.06) increased odds of viral suppression, while having a prior TB episode (aOR 0.45, 95% CI: 0.31 to 0.64), having a detectable viral load at MDR-TB treatment initiation (aOR 0.17, 95% CI: 0.09 to 0.30), living in a township (aOR 0.49, 95% CI: 0.28 to 0.87), and being changed from efavirenz-based antiretroviral therapy (ART) to a protease inhibitor due to bedaquiline usage (aOR 0.19, 95% CI: 0.04 to 0.82) or not having an ART change while on bedaquiline (aOR 0.29, 95% CI: 0.11 to 0.75) lowered odds of viral suppression. Changing from efavirenz to nevirapine due to bedaquiline usage did not significantly affect odds of viral suppression (aOR 0.41, 95% CI: 0.16 to 1.04).Conclusions:Increased pill burden and adverse treatment effects did not significantly affect HIV viral suppression while switching ART to a protease inhibitor to accommodate bedaquiline or not changing ART while taking bedaquiline did, suggesting that PWH and MDR-TB may benefit from additional support if they must switch ART.

100 Deals associated with TNP-2500

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Indication	Highest Phase	Country/Location	Organization	Date
Bacterial Infections	Preclinical	CN	TenNor Therapeutics Suzhou Ltd.	-
Tuberculosis	Preclinical	US	-	-

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