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Guglielmetti L, Günther G, Leu C, Cirillo D, Duarte R, Garcia-Basteiro AL, Goletti D, Jankovic M, Kuksa L, Maurer FP, Méchaï F, Tiberi S, van Leth F, Veziris N, Lange C. Rifapentine access in Europe: growing concerns over key tuberculosis treatment component. Eur Respir J 2022; 59:59/5/2200388. [PMID: 35589114 PMCID: PMC9186306 DOI: 10.1183/13993003.00388-2022] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/06/2022] [Indexed: 12/02/2022]
Abstract
Rifapentine, a synthetic derivate of rifampicin which was developed in 1965, has interesting pharmacological properties, including a long terminal half-life (13 h, compared to 2–3 h for rifampicin) and promising bactericidal activity against Mycobacterium tuberculosis. Despite being approved in 1998 by the US Food and Drug Administration (FDA) for the treatment of pulmonary tuberculosis, its global use has been limited by unavailability. In the past decade, new evidence has emerged to define rifapentine as a key component for treatment of active disease and latent infection with M. tuberculosis (LTBI). Lack of access to rifapentine in Europe denies patients optimal care for active tuberculosis and latent tuberculosis infection, and deprives healthcare providers of adequate tools to pursue tuberculosis control and eliminationhttps://bit.ly/3jz85eh
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Affiliation(s)
- Lorenzo Guglielmetti
- Sorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France .,APHP, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France.,APHP, Infectious Disease Unit, Avicenne Hospital, Bobigny, France
| | - Gunar Günther
- Department of Pulmonology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Internal Medicine, School of Medicine, University of Namibia, Windhoek, Namibia
| | - Claude Leu
- Department of Pulmonology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniela Cirillo
- WHO Collaborating Centre and TB Supranational Reference Laboratory, San Raffaele Scientific Institute, Milano, Italy
| | - Raquel Duarte
- Epidemiology Research Unit (EpiUnit), Institute of Public Health, University of Porto, Porto, Portugal.,Departamento de Ciências de Saúde Pública, Ciências Forenses e Educação Médica, Faculty of Medicine, University of Porto, Porto, Portugal.,Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.,National Tuberculosis Program, Directorate-General of Health, Lisbon, Portugal
| | - Alberto L Garcia-Basteiro
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique.,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Delia Goletti
- National Institute for Infectious Diseases L. Spallanzani-IRCCS, Rome, Italy
| | - Mateja Jankovic
- Clinic for Lung Diseases, University of Zagreb School of Medicine and University Hospital Center Zagreb, Zagreb, Croatia
| | - Liga Kuksa
- Riga East University Hospital, TB and Lung Disease Centre, Riga, Latvia.,Riga Stradins University, Riga, Latvia
| | - Florian P Maurer
- National and Supranational Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany.,Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany
| | - Frédéric Méchaï
- APHP, Infectious Disease Unit, Avicenne Hospital, Université Paris 13, IAME, INSERM, Bobigny, France
| | - Simon Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University, London, UK.,Royal London Hospital, Barts Health National Health Service Trust, London, UK
| | - Frank van Leth
- VU University, Department of Health Sciences, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Nicolas Veziris
- APHP, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France.,APHP, Groupe Hospitalier Universitaire Sorbonne Université, site Saint-Antoine, Département de bactériologie, Paris, France.,Sorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, équipe 13, Paris, France
| | - Christoph Lange
- German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany.,Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.,Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany.,Baylor College of Medicine and Texas Childreńs Hospital, Global TB Program, Houston, TX, USA
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Tunesi S, Dû DL, Gualano G, Millet JP, Skrahin A, Bothamley G, Casas X, Goletti D, Lange C, Musso M, Palmieri F, Pourcher V, Rioux C, Skrahina A, Veziris N, Viatushka D, Jachym-Fréchet M, Guglielmetti L. Co-administration of treatment for rifampicin-resistant TB and chronic HCV infection: a TBnet and ESGMYC study. J Infect 2022; 84:834-872. [DOI: 10.1016/j.jinf.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
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Günther G, Heyckendorf J, Zellweger JP, Reimann M, Claassens M, Chesov D, van Leth F. Defining Outcomes of Tuberculosis (Treatment): From the Past to the Future. Respiration 2021; 100:843-852. [PMID: 34058739 DOI: 10.1159/000516392] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 04/07/2021] [Indexed: 11/19/2022] Open
Abstract
Untreated active tuberculosis (TB) has a very high long-term mortality. Treatment of TB reduces mortality dramatically and should maximize cure, preventing ongoing transmission and TB sequelae. However, predicting the risk of failure and relapse is crucial for the management of individual patients and for the evaluation of effectiveness of programs. Various outcome definitions for drug-sensitive and drug-resistant TB were developed, implemented, and endorsed since introduction of TB chemotherapy by the World Health Organization (WHO), mostly based on culture and smear results. They should be applicable for individual patient care, surveillance, and research. Definitions with focus on program evaluation differ from definitions to evaluate the efficacy and effectiveness of regimens. Lack of sputum production at the later stage of treatment reduces the easy applicability of current definitions. Definitions of failure and cure are sometimes difficult to apply. Alternative approaches suggest culture positivity at 6 months or more of treatment as an indicator for failure. New definitions for cure including a relapse-free period posttreatment and reduced number of culture and smear results are considered. Increasing variation and individualization of treatment and its duration urgently require new approaches using pathogen- or host-specific biomarkers, which indicate risk of failure and define cure. Such biomarkers are under evaluation but still far from translation in clinical routine practice.
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Affiliation(s)
- Gunar Günther
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Internal Medicine, School of Medicine, University of Namibia, Windhoek, Namibia
| | - Jan Heyckendorf
- Research Center Borstel, Borstel, Germany.,German Center for Infection Research (DZIF), Germany.,International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
| | | | - Maja Reimann
- Research Center Borstel, Borstel, Germany.,German Center for Infection Research (DZIF), Germany.,International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
| | - Mareli Claassens
- Department of Internal Medicine, School of Medicine, University of Namibia, Windhoek, Namibia.,Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dumitru Chesov
- Research Center Borstel, Borstel, Germany.,State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Moldova
| | - Frank van Leth
- Department of Health Sciences, Faculty of Science, VU Amsterdam, Amsterdam, The Netherlands
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4
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Stellmacher F, Perner S. [Overview: granulomatous diseases of the lung]. DER PATHOLOGE 2021; 42:64-70. [PMID: 33475808 DOI: 10.1007/s00292-020-00893-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 11/26/2022]
Abstract
The spectrum of pulmonary granulomatoses is wide and includes infectious and noninfectious entities, each with very different therapeutic consequences. The first step of histological examination discriminates between necrotizing and non-necrotizing granulomatosis. After this, an infectious cause of the granulomatosis has to be excluded by special histological stains and molecular-pathologic methods, if necessary. Diagnosis also includes clinical, radiological, and microbiological findings. The process of pathological examination should be standardized as described.
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Affiliation(s)
- Florian Stellmacher
- Pathologie, Forschungszentrum Borstel, Leibniz Lungenzentrum, Parkallee 1-40, 23845, Borstel, Deutschland.
| | - Sven Perner
- Pathologie, Forschungszentrum Borstel, Leibniz Lungenzentrum, Parkallee 1-40, 23845, Borstel, Deutschland
- Institut für Pathologie, Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
- Airwary Research Center North (ARCN), Deutsches Zentrum für Lungenforschung (DZL), Gießen, Deutschland
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Agusti A, Faner R, Donaldson G, Heuvelin E, Breyer-Kohansal R, Melén E, Maitland-van der Zee AH, Vestbo J, Allinson JP, Vanfleteren LEGW, van den Berge M, Adcock IM, Lahousse L, Brusselle G, Wedzicha JA. Chronic Airway Diseases Early Stratification (CADSET): a new ERS Clinical Research Collaboration. Eur Respir J 2019; 53:53/3/1900217. [PMID: 30886026 DOI: 10.1183/13993003.00217-2019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/03/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Alvar Agusti
- Respiratory Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain.,CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - Rosa Faner
- CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - Gavin Donaldson
- Asthma and COPD Group, Airways Disease Section, Imperial College London, National Heart and Lung Institute, London, UK
| | | | - Robab Breyer-Kohansal
- Dept of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Erik Melén
- Sachs' Children's Hospital and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anke H Maitland-van der Zee
- Dept of Respiratory Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.,Pediatric Respiratory Medicine, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Jørgen Vestbo
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, and Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
| | - James P Allinson
- Asthma and COPD Group, Airways Disease Section, Imperial College London, National Heart and Lung Institute, London, UK
| | - Lowie E G W Vanfleteren
- COPD Center, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Maarten van den Berge
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ian M Adcock
- Cell and Molecular Biology Group, Airways Disease Section, Imperial College London, National Heart and Lung Institute, London, UK
| | | | | | - Jadwiga A Wedzicha
- Asthma and COPD Group, Airways Disease Section, Imperial College London, National Heart and Lung Institute, London, UK
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