Efficacy and safety of treatment regimens for drug-resistant tuberculosis in different regions: a systematic review and meta-analysis
Abstract
BACKGROUND: Drug-resistant tuberculosis (DR-TB) remains a formidable public health challenge, posing a significant threat to human life and health security. Comprehensive comparative evidence on the efficacy and safety of various DR-TB treatment strategies remains limited. This study aimed to systematically evaluate and compare the effectiveness of different DR-TB treatment regimens and to assess their safety profiles based on the frequency of adverse events and drug-specific reactions. METHODS: We systematically searched PubMed, Web of Science, and Embase for relevant studies published between 2006 and 2025. Data on drug-resistant tuberculosis and treatment regimens were extracted. Pooled rates and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Publication bias was assessed using Begg’s and Egger’s tests. RESULTS: A total of 97 studies were included for systematic review and meta-analysis. This analysis found that Europe had the highest cure rate for DR-TB (84%; 95% CI: 76%-91%). The cure rate was highest for the 6-month treatment regimen (BPaL) (93%; 95% CI: 88%-96%), followed by the HRZE treatment regimen (86%; 95% CI: 82%-89%), and the lowest for the 18–24 month long-term treatment regimen including injectable agents (62%; 95% CI: 55%-70%). The overall incidence of adverse events (AEs) was 65% (95% CI: 50%-78%), and the incidence of serious adverse events (SAEs) was 17% (95% CI: 12%-24%). The BPaL regimen was associated with a lower incidence of…
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