Evidence map›Paper›PMID 36043179›Full record

ArticleOpen forum infectious diseases2022

Model-Predicted Impact of ECG Monitoring Strategies During Bedaquiline Treatment.

Stijn W van Beek, Lénaïg Tanneau, Graeme Meintjes, Sean Wasserman, Neel R Gandhi, Angie Campbell, Charle A Viljoen, Lubbe Wiesner, Rob E Aarnoutse, Gary Maartens and 2 more

Open access · goldAbstract read
In one paragraph

Article in Open forum infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 9 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 4 countries.

Stijn W van BeekDepartment of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID https://orcid.org/0000-0001-8020-1934
Lénaïg TanneauDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.
Graeme MeintjesDepartment of Medicine, Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Sean WassermanDepartment of Medicine, Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Neel R GandhiDepartments of Epidemiology & Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0003-1758-1764
Angie CampbellDepartments of Epidemiology & Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Charle A ViljoenDivision of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Lubbe WiesnerDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-9070-8699
Rob E AarnoutseDepartment of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Gary MaartensDepartment of Medicine, Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0003-3080-6606
James C M BrustDivision of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Elin M SvenssonDepartment of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
University of Cape Town · ZAEmory University · USRadboud University Nijmegen · NLUppsala University · SEAlbert Einstein College of Medicine · US

Funding

Virology and Molecular Biomarkers CoreP30AI050409 · NIAID · EMORY UNIVERSITY · PI Ann M Chahroudi, Colleen F Kelley · 2002 to 2026
$74.0M
Patient and Population Health Outcomes Research SWGP30AI124414 · NIAID · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI Vinayaka R. Prasad · 2017 to 2026
$28.3M
CTSA Administrative Supplement for Informatics Core: A novel AI/ML system to predict respiratory failure and ARDS in Covid-19 patientsUL1TR002556 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI KELLER, MARLA J, KIM, MIMI Y · 2018 to 2022
$26.7M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
Role of antigen-specific T cell responses in the control of TBU19AI111211 · NIAID · EMORY UNIVERSITY · PI BLUMBERG, HENRY M · 2014 to 2020
$20.1M
Emory/Georgia TB Research Advancement Center (TRAC)P30AI168386 · NIAID · EMORY UNIVERSITY · PI Neel Rajnikant Gandhi, Jyothi Rengarajan · 2022 to 2026
$5.8M
Safety, pharmacokinetics, and resistance to bedaquiline in XDR TB and HIVR01AI114304 · NIAID · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI BRUST, JAMES C M · 2015 to 2019
$3.7M
Emergence of bedaquiline and clofazimine resistance after interruption of drug-resistant TB therapy in a high HIV prevalence settingR01AI145679 · NIAID · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI BRUST, JAMES C M · 2020 to 2025
$3.6M
Mentorship in Patient-Oriented Research in Tuberculosis, HIV and Global HealthK24AI114444 · NIAID · EMORY UNIVERSITY · PI GANDHI, NEEL RAJNIKANT · 2014 to 2023
$1.8M
Mentoring of multidisciplinary global health research in tuberculosis and HIVK24AI155045 · NIAID · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI BRUST, JAMES C M · 2020 to 2025
$889k
Characterizing the pharmacokinetics of high dose rifampicin and linezolid in a randomized controlled trial for HIV-associated tuberculous meningitisK43TW011421 · FIC · UNIVERSITY OF CAPE TOWN · PI WASSERMAN, SEAN ADAM · 2019 to 2022
$404k
FIC NIH HHS K43 TW011421NCATS NIH HHS UL1 TR000454NCATS NIH HHS UL1 TR002556NIAID NIH HHS K24 AI114444NIAID NIH HHS K24 AI155045NIAID NIH HHS P30 AI050409NIAID NIH HHS P30 AI124414NIAID NIH HHS P30 AI168386NIAID NIH HHS R01 AI114304NIAID NIH HHS R01 AI145679NIAID NIH HHS U19 AI111211Wellcome Trust
6 · The paper itself

Abstract

Background: The M2 metabolite of bedaquiline causes QT-interval prolongation, making electrocardiogram (ECG) monitoring of patients receiving bedaquiline for drug-resistant tuberculosis necessary. The objective of this study was to determine the relationship between M2 exposure and Fridericia-corrected QT (QTcF)-interval prolongation and to explore suitable ECG monitoring strategies for 6-month bedaquiline treatment. Methods: Data from the PROBeX study, a prospective observational cohort study, were used to characterize the relationship between M2 exposure and QTcF. Established nonlinear mixed-effects models were fitted to pharmacokinetic and ECG data. In a virtual patient population, QTcF values were simulated for scenarios with and without concomitant clofazimine. ECG monitoring strategies to identify patients who need to interrupt treatment (QTcF > 500 ms) were explored. Results: One hundred seventy patients were included, providing 1131 bedaquiline/M2 plasma concentrations and 1702 QTcF measurements; 2.1% of virtual patients receiving concomitant clofazimine had QTcF > 500 ms at any point during treatment (0.7% without concomitant clofazimine). With monthly monitoring, almost all patients with QTcF > 500 ms were identified by week 12; after week 12, patients were predominantly falsely identified as QTcF > 500 ms due to stochastic measurement error. Following a strategy with monitoring before treatment and at weeks 2, 4, 8, and 12 in simulations with concomitant clofazimine, 93.8% of all patients who should interrupt treatment were identified, and 26.4% of all interruptions were unnecessary (92.1% and 32.2%, respectively, without concomitant clofazimine). Conclusions: Our simulations enable an informed decision for a suitable ECG monitoring strategy by weighing the risk of missing patients with QTcF > 500 ms and that of interrupting bedaquiline treatment unnecessarily. We propose ECG monitoring before treatment and at weeks 2, 4, 8, and 12 after starting bedaquiline treatment.

Indexed as

bedaquilineECG monitoringmodelingQT-interval prolongationtuberculosis

Identifiers

PMID36043179
PMCPMC9420883
OpenAlexW4288052254

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.