ArticleThe Lancet regional health. Europe2025
Treatment outcomes of extensively drug-resistant tuberculosis in Europe: a retrospective cohort study.
Article in The Lancet regional health. Europe, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- A call to action on antimicrobial stewardship in tuberculosis: safeguarding effective tuberculosis treatment for future generations.The Lancet regional health. Europe · 2026Article
- We Are Underprepared for Bedaquiline Resistance: A Call for Clinical and Programmatic Readiness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Treatment outcomes and long-term relapse-free survival after multidrug-resistant tuberculosis treatment in Latvia: a retrospective national cohort study.The Lancet regional health. Europe · 2026Article
- Rising bedaquiline resistance: exploring potential causes and next steps.The European respiratory journal · 2026Article
- Breaking barriers in extensively drug-resistant TB: pretomanid-centred long regimen achieves cure in a bedaquiline-resistant strain.IJTLD open · 2026Article
- Spatial Epidemiological Approach to Tuberculosis Treatment Outcomes in a Tertiary-Level Hospital: A Retrospective Analysis.Tropical medicine and infectious disease · 2026Article
- A Year in Review on Tuberculosis and Non-tuberculous Mycobacteria Disease: A 2026 Update for Clinicians and Scientists.Pathogens & immunity · 2026Review
- Current and emerging therapies for pulmonary tuberculosis in adults.BMJ medicine · 2026Review
- Diagnostic algorithms for tuberculosis in Europe: insights from the European Reference Laboratory Network for Tuberculosis (ERLTB-Net).The Lancet regional health. Europe · 2026Review
- Relapse and Emergent Resistance With Novel Short-Course Regimens for Multidrug-Resistant Tuberculosis, United States, 2022-2024.Open forum infectious diseases · 2026Article
- The time is now: making the case for compassionate use/pre-approval access to new TB drugs.IJTLD open · 2025Article
- New drugs for the management of tuberculosis.Current opinion in infectious diseases · 2025Review
- Tracking the evolution of an extensively drug-resistant cross-borderEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
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Authors and funding
20 authors.
Funding
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Abstract
Background: In 2021, World Health Organization revised of definition of extensive drug-resistant tuberculosis. We aimed to determine treatment outcomes of individuals affected by extensively drug-resistant tuberculosis in Europe. Methods: This observational, retrospective cohort study included patients diagnosed with extensively drug-resistant tuberculosis in the World Health Organization European Region from 2017 to 2023. Participating centres collected consecutive, detailed individual data for extensively drug-resistant tuberculosis patients. Data were analysed with meta- and regression methods, accounting for between-country heterogeneity. Findings: Among 11,003 patients with multidrug-resistant/rifampicin-resistant tuberculosis, 188 (1·7%) from 16 countries had extensively drug-resistant tuberculosis. Of these, 48·4% harboured strains with resistance to bedaquiline (n = 91/188), 34·0% to linezolid (n = 64/188), and 17·6% to both (n = 33/188). The individual composition of anti-tuberculosis regimens was highly variable, with 151 different drug combinations. Among the 156/188 (83·0%) patients with available treatment outcomes, the pooled percentage of successful outcomes was 40·2% (95% confidence interval [95% CI] 28·4%-53·2%). In patients with unsuccessful treatment outcomes (101/156), most experienced treatment failure (n = 57/156 [pooled proportion 37·1%], 95% CI: 26·1%-49·7%) or death (n = 30/156 [pooled proportion 21·3%], 95% CI: 15·7%-28·2%). After adjustment for disease severity, each additional likely effective drug decreased the odds of unsuccessful outcomes (adjusted odds ratio: 0·65, 95% CI: 0·45-0·96) (p = 0·026), whereas being treated in an upper-middle-income country increased the odds of unsuccessful outcomes compared with being treated in a high-income country (adjusted odds ratio: 13·7, 95% CI: 3·7-50·2) (p < 0·001). Compared with other levels of drug resistance, treatment outcomes were significantly worse for extensively drug-resistant tuberculosis. Interpretation: Only four out of ten patients affected by extensively drug-resistant tuberculosis achieved successful treatment outcomes. These findings highlight the need for adequate, individualised treatment regimens and optimised drug susceptibility testing. Funding: None.
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