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Introduction <p>Bedaquiline (BDQ) is recommended in China as component of oral short-course regimens (SCR) for MDR-TB patients. However, the efficacy and safety of BDQ containing oral SCRs remain insufficiently validated in large-scale, well-designed clinical trials involving the Chinese population.</p> Methods <p>A randomized, non-inferiority, open-label trial was conducted at 17 hospital clinics in China, enrolling adult patients with MDR-TB. Participants were assigned in a 1:1 ratio to receive either a 40-week oral BDQ-containing SCR or a 40-week oral non BDQ-containing SCR. The primary endpoint was the proportion of participants achieving favorable outcome at the end of treatment. The non-inferiority margin of the difference in proportion between the BDQ and control groups in the modified intent-to-treat (mITT) population was set at -15%.</p> Results <p>A total of 217 participants were randomized. Among 182 patients in the mITT population, the BDQ-containing SCR group achieved an 80.0% favorable outcome compared to 59.8% in the non-BDQ group, with an adjusted difference of 22.27% (95% CI 9.41–35.13%). BDQ-containing SCR was also associated with higher proportions of modified favorable outcomes and cure rates. Additionally, BDQ-containing SCR resulted in a higher culture conversion rate at the end of treatment and a shorter time to culture conversion. Serious adverse events occurred in 16 of 110 participants (14.5%) in the BDQ-containing SCR group and 25 of 107 participants (23.4%) in the non-BDQ-containing SCR group.</p> Conclusion <p>40-week BDQ-SCR proved non-inferior and superior, safe, and well tolerated in Chinese patients with MDR-TB. Further investigation into the long-term safety and efficacy of the BDQ-containing regimen is still needed in China. ClinicalTrials.gov NCT05306223. Prospectively registered on 16 March 2022.</p>

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Evaluation of an oral bedaquiline regimen for treating multidrug-resistant TB in China: a randomized trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月2日

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  • Jingtao Gao,
  • Zhongfeng Huang,
  • Fei Ren,
  • Yuqing Wu,
  • Hua Wang,
  • Guihui Wu,
  • Juan Du,
  • Xiaofeng Yan,
  • Yi Pei,
  • Long Jin,
  • Yu Xiong,
  • Lian Shi,
  • Junwei Cui,
  • Xiaohong Chen,
  • Xiujie Li,
  • Wei Sha,
  • Huiru An,
  • Katleen Callewaert,
  • Nacer Lounis,
  • Nyasha Bakare,
  • Yanxin Jiang,
  • Ruiqi Zhang,
  • Lu Wang,
  • Mengqiu Gao,
  • Liang Li

摘要

Introduction

Bedaquiline (BDQ) is recommended in China as component of oral short-course regimens (SCR) for MDR-TB patients. However, the efficacy and safety of BDQ containing oral SCRs remain insufficiently validated in large-scale, well-designed clinical trials involving the Chinese population.

Methods

A randomized, non-inferiority, open-label trial was conducted at 17 hospital clinics in China, enrolling adult patients with MDR-TB. Participants were assigned in a 1:1 ratio to receive either a 40-week oral BDQ-containing SCR or a 40-week oral non BDQ-containing SCR. The primary endpoint was the proportion of participants achieving favorable outcome at the end of treatment. The non-inferiority margin of the difference in proportion between the BDQ and control groups in the modified intent-to-treat (mITT) population was set at -15%.

Results

A total of 217 participants were randomized. Among 182 patients in the mITT population, the BDQ-containing SCR group achieved an 80.0% favorable outcome compared to 59.8% in the non-BDQ group, with an adjusted difference of 22.27% (95% CI 9.41–35.13%). BDQ-containing SCR was also associated with higher proportions of modified favorable outcomes and cure rates. Additionally, BDQ-containing SCR resulted in a higher culture conversion rate at the end of treatment and a shorter time to culture conversion. Serious adverse events occurred in 16 of 110 participants (14.5%) in the BDQ-containing SCR group and 25 of 107 participants (23.4%) in the non-BDQ-containing SCR group.

Conclusion

40-week BDQ-SCR proved non-inferior and superior, safe, and well tolerated in Chinese patients with MDR-TB. Further investigation into the long-term safety and efficacy of the BDQ-containing regimen is still needed in China. ClinicalTrials.gov NCT05306223. Prospectively registered on 16 March 2022.