Evidence map›Paper›PMID 39087258›Full record

Trial reportThe Journal of antimicrobial chemotherapy2024

A pharmacometric multistate model for predicting long-term treatment outcomes of patients with pulmonary TB.

Yu-Jou Lin, Yuanxi Zou, Mats O Karlsson, Elin M Svensson

Abstract readClinical Trial, Phase II
In one paragraph

Trial report in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

4 authors.

Yu-Jou LinDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.ORCID 0009-0008-7501-5326
Yuanxi ZouDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.
Mats O KarlssonDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.
Elin M SvenssonDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.

Funding

Janssen Pharmaceuticals 09150161910052NWOUppsala University
6 · The paper itself

Abstract

backgroundStudying long-term treatment outcomes of TB is time-consuming and impractical. Early and reliable biomarkers reflecting treatment response and capable of predicting long-term outcomes are urgently needed.

objectivesTo develop a pharmacometric multistate model to evaluate the link between potential predictors and long-term outcomes.

methodsData were obtained from two Phase II clinical trials (TMC207-C208 and TMC207-C209) with bedaquiline on top of a multidrug background regimen. Patients were typically followed throughout a 24 week investigational treatment period plus a 96 week follow-up period. A five-state multistate model (active TB, converted, recurrent TB, dropout, and death) was developed to describe observed transitions. Evaluated predictors included patient characteristics, baseline TB disease severity and on-treatment biomarkers.

resultsA fast bacterial clearance in the first 2 weeks and low TB bacterial burden at baseline increased probability to achieve conversion, whereas patients with XDR-TB were less likely to reach conversion. Higher estimated mycobacterial load at the end of 24 week treatment increased the probability of recurrence. At 120 weeks, the model predicted 55% (95% prediction interval, 50%-60%), 6.5% (4.2%-9.0%) and 7.5% (5.2%-10%) of patients in converted, recurrent TB and death states, respectively. Simulations predicted a substantial increase of recurrence after 24 weeks in patients with slow bacterial clearance regardless of baseline bacterial burden.

conclusionsThe developed multistate model successfully described TB treatment outcomes. The multistate modelling framework enables prediction of several outcomes simultaneously, and allows mechanistically sound investigation of novel promising predictors. This may help support future biomarker evaluation, clinical trial design and analysis.

Indexed as

Antitubercular AgentsDiarylquinolinesTuberculosis, PulmonaryAdultAgedBacterial LoadFemaleHumansMaleMiddle AgedModels, StatisticalMycobacterium tuberculosisRecurrenceTreatment OutcomeYoung AdultAntitubercular AgentsbedaquilineDiarylquinolines

Identifiers

PMID39087258
PMCPMC11441995

What Socratic holds

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LicenceCC BY
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Registered trials

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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 Socratic graph.