16 October 2017

Namibia: Multi-Drug Resistant TB Drugs' Side Effects Can Be Controlled

Windhoek — A recent study titled 'Optimizing the safety of multidrug-resistant (MDR) tuberculosis therapy in Namibia', by Evans Sagwa, showed that side effects occur frequently in patients treated with current second-line anti-TB drugs.

MDR-TB is a form of tuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications - isoniazid and rifampin (drugs).

Most of the MDR TB side effects occur during the intensive phase of therapy and are preventable, Sagwa's study revealed.

The study showed that certain MDR drugs are potentially harmful to patients, which may diminish patients' health-related quality of life.

Other clinically important overlapping side effects may occur in MDR TB patients simultaneously taking antiretroviral medicines.

Despite the safety and efficacy concerns with current second-line anti-TB drugs, these drugs are still needed in the treatment of MDR-TB, the study highlighted.

"The focus, therefore, remains on ensuring the safer use of current and new anti-TB drugs," suggests the study.

The monitoring and management of adverse events should be done regularly throughout MDR-TB therapy and pharmacovigilance systems should be strengthened, including active surveillance, Sagwa's study suggested.

The long-term impact of side effects on patients' health-related quality of life after completing MDR-TB treatment should be ascertained, the study by Sagwa, who is a pharmaceutical management expert in Namibia, recommends.

"More investment is needed in developing novel, safer and more effective anti-mycobacterial compounds," suggests the study.

The study also found that clinicians in Namibia were found to use a number of strategies to alleviate the discomfort and to reduce the potential harm of side effects associated with the treatment of MDR-TB. This is in line with the Namibian TB treatment guidelines.

"The study found that clinicians may reduce the dose of the specific (suspected) offending medicine, stop, change, or replace the suspected medicine," according to the study.

Furthermore, the success of MDR-TB treatment requires the full cooperation of patients and their complete adherence to treatment, even in the face of side effects. Knowing that side effects are common and pose a challenge in MDR-TB treatment, said Sagwa.

"Although MDR-TB disease may be considered as an old problem, new therapeutic solutions are urgently required. Looking at the long-term safety profile of aminoglycosides and capreomycin and considering the patient discomfort from the frequent painful injections of this category of drugs, there is a pressing need for novel, safer medicines that can be administered orally as shorter, efficacious MDR-TB regimens," suggests the study.

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