Evidence map›Paper›PMID 39731394›Full record

ArticleClinical pharmacology and therapeutics2025

Model-Informed Once-Daily Dosing Strategy for Bedaquiline and Delamanid in Children, Adolescents and Adults with Tuberculosis.

Yu-Jou Lin, Louvina E van der Laan, Mats O Karlsson, Anthony J Garcia-Prats, Anneke C Hesseling, Elin M Svensson

Erratum issuedAbstract read
In one paragraph

Article in Clinical pharmacology and therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Yu-Jou LinDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.ORCID 0009-0008-7501-5326
Louvina E van der LaanDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Desmond Tutu TB Centre, Stellenbosch University, Stellenbosch, South Africa.ORCID 0000-0002-3584-7477
Mats O KarlssonDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.ORCID 0000-0003-1258-8297
Anthony J Garcia-PratsDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Desmond Tutu TB Centre, Stellenbosch University, Stellenbosch, South Africa.ORCID 0000-0002-9280-1950
Anneke C HesselingDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Desmond Tutu TB Centre, Stellenbosch University, Stellenbosch, South Africa.ORCID 0000-0001-9399-9834
Elin M SvenssonDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.ORCID 0000-0002-0093-6445

Funding

LOC-IMPAACT Leadership GroupPharmacokinetics and Safety of Remdesivir for Treatment of COVID-19 in Pregnant Women in the USUM1AI068632 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI Jennifer Jao, Sharon A Nachman · 2011 to 2026
$278.1M
Statistical and Data Management Center-Pediatric,Adolescent, and Maternal CTGUM1AI068616 · NIAID · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Sean Scott Brummel, Marlene Ann Cooper · 2011 to 2026
$155.6M
LC - IMPAACT Leadership GroupUM1AI106716 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Grace M Aldrovandi · 2014 to 2026
$47.2M
Stellenbosch University Clinical Trial Unit, Cape Town, South AfricaUM1AI069521 · NIAID · STELLENBOSCH UNIVERSITY · PI Shaun Barnabas, Anneke Catharina Hesseling · 2012 to 2026
$21.5M
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)Innovative Medicines Initiative 2 Joint Undertaking 101007873National Institute of Allergy and Infectious Diseases (NIAID)National Institute of Mental Health (NIMH)NIAID NIH HHS UM1 AI068616NIAID NIH HHS UM1 AI068632NIAID NIH HHS UM1 AI069521NIAID NIH HHS UM1 AI106716NICHDNIH HHS UM1AI068616NIH HHS UM1AI068632NIH HHS UM1AI106716
6 · The paper itself

Abstract

The complexity of the currently registered dosing schedules for bedaquiline and delamanid is a barrier to uptake in drug-resistant tuberculosis treatment across all ages. A simpler once-daily dosing schedule is critical to ensure patient-friendly regimens with good adherence. We assessed expected drug exposures with proposed once-daily doses for adults and compared novel model-informed once-daily dosing strategies for children with current World Health Organization (WHO) recommended dosing. A reference individual and virtual pediatric population were generated to simulate exposures in adults and children, respectively. Published population models characterizing the exposures of bedaquiline and its metabolite M2, delamanid, and its metabolite DM-6705 were utilized. During simulation, child growth during treatment along with several CYP3A4 ontogeny profiles was accounted for. Exposures in children were compared with simulated adult targets to assess the expected treatment efficacy and safety. In adults, the proposed bedaquiline once-daily dosing (400 mg daily for 2 weeks followed by 100 mg daily for 22 weeks) yielded 14% higher exposures of bedaquiline and M2 compared to the labeled dosing scheme at 24 weeks; for delamanid and DM-6705, the suggested 300 mg daily dose provided 13% lower exposures at steady state. For children, the cumulative proportions of exposures of both drugs showed < 5% difference between WHO-recommended and proposed once-daily dosing. This study demonstrated the use of model-informed approaches to propose rational and simpler regimens for bedaquiline and delamanid in adults and children. The new once-daily dosing strategies will be tested in the PARADIGM4TB and IMPAACT 2020 trials in adults and children, respectively.

Indexed as

Antitubercular AgentsDiarylquinolinesModels, BiologicalNitroimidazolesOxazolesTuberculosisTuberculosis, Multidrug-ResistantAdolescentAdultAge FactorsChildChild, PreschoolComputer SimulationDrug Administration ScheduleFemaleHumansAntitubercular AgentsbedaquilineDiarylquinolinesNitroimidazolesOPC-67683Oxazoles

Identifiers

PMID39731394
PMCPMC11993290

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.