Evidence map›Paper›PMID 40613338›Full record

Trial reportThe Journal of antimicrobial chemotherapy2025

Cardiac safety of bedaquiline, delamanid and moxifloxacin co-administered with or without varying doses of sutezolid or delpazolid for the treatment of drug-susceptible TB.

Simon E Koele, Krista Stoycheva, Cyprian Mtweve, Christina Manyama, Stellah Mpagama, Francis Mhimbira, Robert Wallis, Nyanda Elias Ntinginya, Alphonce Liyoyo, Beno Huglin and 19 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Trial
  2. Review
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

29 authors.

Simon E KoeleDepartment of Pharmacy, Pharmacology, and Toxicology, Radboud Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-7011-667X
Krista StoychevaInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
Cyprian MtweveNational Institute for Medical Research-Mbeya Medical Research Centre, Mbeya, Tanzania.
Christina ManyamaInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
Stellah MpagamaKibon'goto Infectious Disease Hospital, Moshi, Tanzania.
Francis MhimbiraIfakara Health Institute, Bagamoyo Research and Training Unit, Dar es Salaam, Tanzania.
Robert WallisThe Aurum Institute, Johannesburg, South Africa.
Nyanda Elias NtinginyaNational Institute for Medical Research-Mbeya Medical Research Centre, Mbeya, Tanzania.
Alphonce LiyoyoKibon'goto Infectious Disease Hospital, Moshi, Tanzania.
Beno HuglinIfakara Health Institute, Bagamoyo Research and Training Unit, Dar es Salaam, Tanzania.
Lilian Tina MinjaNational Institute for Medical Research-Mbeya Medical Research Centre, Mbeya, Tanzania.
Larissa WagnerbergerInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
Tresphory ZumbaIfakara Health Institute, Bagamoyo Research and Training Unit, Dar es Salaam, Tanzania.
Ivan NoreñaInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
Daud D PeterKibon'goto Infectious Disease Hospital, Moshi, Tanzania.
Trevor BeattieThe Aurum Institute, Johannesburg, South Africa.
Heeran MakkanThe Aurum Institute, Johannesburg, South Africa.
Derek J SloanUniversity of St Andrews, St Andrews, UK.
Lindsey Te BrakeDepartment of Pharmacy, Pharmacology, and Toxicology, Radboud Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
Rob E AarnoutseDepartment of Pharmacy, Pharmacology, and Toxicology, Radboud Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
Timothy D McHughUCL Centre for Clinical Microbiology, University College London, London, UK.
Leticia WildnerUCL Centre for Clinical Microbiology, University College London, London, UK.
Jodie SchildkrautDepartment of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-7236-8934
Brian H AldanaUCSF Center for Tuberculosis, University of California San Francisco, San Francisco, USA.
Patrick P J PhillipsUCSF Center for Tuberculosis, University of California San Francisco, San Francisco, USA.
Michael HoelscherInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany.ORCID 0000-0002-7642-1835
Elin M SvenssonDepartment of Pharmacy, Pharmacology, and Toxicology, Radboud Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.
Norbert HeinrichInstitute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
PanACEA consortium

Funding

EDCTP2 programme TRIA2015-1102German Center for Infection ResearchGerman Ministry for Education and Research 01KA1701Nederlandse Organisatie voor Wetenschappelijk OnderzoekSwiss State Secretariat for Education, Research, and Innovation
6 · The paper itself

Abstract

introductionMany drugs for the treatment of TB prolong the QTc interval, which is associated with an increased risk of developing a life-threatening arrhythmia known as torsades de pointes. Sutezolid and delpazolid are novel oxazolidinones with demonstrated bactericidal activity. We aimed to assess the effects of sutezolid or delpazolid co-administered with bedaquiline, delamanid and moxifloxacin on the QTcF interval (Fridericia's correction). Furthermore, we developed a population pharmacodynamic model to assess the effects of drug exposure on the QTcTBT interval (TB-specific correction).

methodsParticipants were randomized to receive standard-dose bedaquiline, delamanid and moxifloxacin with varying doses of either sutezolid (no sutezolid, 600 mg daily, 1200 mg daily, 600 mg twice daily, 800 mg twice daily) or delpazolid (no delpazolid, 400 mg daily, 800 mg daily, 1200 mg daily, 800 mg twice daily). The QTc interval was determined using weekly ECG assessments.

resultsData from 149 participants, yielding 2373 ECG observations were available for analysis. Nine participants (6.0%) experienced a Grade 3 QTcF prolongation as defined by the Common Terminology Criteria for Adverse Events v5.0. The population pharmacodynamic model predicted a 13.2 ms (95% CI: 10.9-15.3) increase of the QTcTBT in the first week of treatment, but no further increase after that. The exposure of bedaquiline's M2 metabolite was found to drive part of the QTcTBT. No exposure-response relationship was identified for the other drugs investigated.

conclusionsThe drug regimens containing standard doses of bedaquiline, delamanid and moxifloxacin, and varying doses of sutezolid or delpazolid were not found to pose a high cardiac risk in a population without further QTc-relevant risk factors. However, close monitoring of the QTc interval remains essential in patients with TB treated with combination drug therapy with known QTc-prolonging drugs.

Indexed as

Antitubercular AgentsDiarylquinolinesMoxifloxacinNitroimidazolesOxazolesOxazolidinonesTuberculosisAdultAgedDrug Therapy, CombinationElectrocardiographyFemaleHumansLong QT SyndromeMaleMiddle AgedAntitubercular AgentsbedaquilineDiarylquinolinesMoxifloxacinNitroimidazolesOPC-67683OxazolesOxazolidinones

Identifiers

PMID40613338
PMCPMC12313457

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.