Nasiri Mohammad Javad, Calcagno Tess, Hosseini Sareh Sadat, Hematian Ali, Nojookambari Neda Yousefi, Karimi-Yazdi Mohammadmahdi, Mirsaeidi Mehdi
Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Medicine, University of Miami, Miami, FL, United States.
Front Med (Lausanne). 2021 Apr 15;8:638306. doi: 10.3389/fmed.2021.638306. eCollection 2021.
Non-tuberculous mycobacteria (NTM), specifically complex (MAC), is an increasingly prevalent cause of pulmonary dysfunction. Clofazimine has been shown to be effective for the treatment of complex, but there were no published large-scale analyses comparing clofazimine to non-clofazimine regimens in MAC treatment. The objective of this large-scale meta-analysis was to evaluate patient characteristics and treatment outcomes of individuals diagnosed with MAC and treated with a clofazimine-based regimen. We used Pubmed/Medline, Embase, Web of Science, and the Cochrane Library to search for studies published from January 1, 1990 to February 9, 2020. Two reviewers (SSH and NY) extracted the data from all eligible studies and differences were resolved by consensus. Statistical analyses were performed with STATA (version 14, IC; Stata Corporation, College Station, TX, USA). The pooled success treatment rate with 95% confidence intervals (CI) was assessed using random effect model. The estimated pooled treatment success rates were 56.8% in clofazimine and 67.9% in non-clofazimine groups. Notably, success rates were higher (58.7%) in treatment of HIV patients with disseminated infection. Treatment was more successful in the non-clofazimine group overall. However, HIV patients with disseminated infection had higher treatment response rates than non-HIV patients within the clofazimine group.
非结核分枝杆菌(NTM),特别是鸟分枝杆菌复合群(MAC),是导致肺功能障碍的一个日益普遍的原因。氯法齐明已被证明对治疗MAC有效,但尚无已发表的大规模分析比较氯法齐明与非氯法齐明方案在MAC治疗中的效果。这项大规模荟萃分析的目的是评估被诊断为MAC并接受基于氯法齐明方案治疗的患者的特征和治疗结果。我们使用PubMed/Medline、Embase、Web of Science和Cochrane图书馆检索1990年1月1日至2020年2月9日发表的研究。两名审稿人(SSH和NY)从所有符合条件的研究中提取数据,分歧通过协商解决。使用STATA(版本14,IC;美国德克萨斯州大学站Stata公司)进行统计分析。使用随机效应模型评估合并成功率及95%置信区间(CI)。氯法齐明组的估计合并治疗成功率为56.8%,非氯法齐明组为67.9%。值得注意的是,在治疗播散性感染的HIV患者中成功率更高(58.7%)。总体而言,非氯法齐明组的治疗更成功。然而,在氯法齐明组中,播散性感染的HIV患者比非HIV患者有更高的治疗反应率。