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Various toxicities and treatment failure: 8 case reports In a retrospective observational study of 74 patients (conducted between March 2016 to December 2018), 8 patients (5 men and 3 women) aged 57–82 years were described, who developed hypoalbuminaemia, end-stage dementia, nausea, vomiting, acute kidney injury, pruritus or Fridericia-corrected QT interval (QTcF prolongation) during treatment with bedaquiline or delamanid for multidrug-resistant tuberculosis (MDR-TB). Additionally, one of the 8 patients exhibited treatment failure during treatment with bedaquiline and delamanid for MDR-TB [dosages, routes, duration of treatments to reaction onsets and outcomes not stated]. The patients, who had MDR-TB, received treatment with delamanid for 14–187 days. Of the 8 patients, one patient received delamanid as off-label therapy for 187 days. The same patient was switched to bedaquiline after an interval of 8 days, and developed ADR in the form of QTcF prolongation secondary to bedaquiline. Hence, bedaquiline was stopped. The remaining 7 patients developed ADRs secondary to delamanid including hypoalbuminaemia (2 patients), nausea and vomiting (4 patients), and acute kidney injury and pruritus (1 patient). Delamanid was then switched to bedaquiline in these 7 patients after 3–81 days. One of the two patients, who developed hypoalbuminaemia, further developed end-stage dementia secondary to bedaquiline, and the drug was stopped. The same patient exhibited treatment failure with bedaquiline and delamanid. The other patient, who developed hypoalbuminaemia, died due to liver cirrhosis. Bedaquiline was administered for a total of 104–168 days, of which, one patient received bedaquiline as off-label treatment for 172 days. Lee HH, et al. Interim treatment outcomes in multidrug-resistant tuberculosis patients treated sequentially with bedaquiline and delamanid. International Journal of Infectious 803504058 Diseases 98: 478-485, Sep 2020. Available from: URL: http://doi.org/10.1016/j.ijid.2020.07.001

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Reactions 3 Oct 2020 No. 1824