Bedaquiline Effect Towards QT Interval in Drug Resistant Tuberculosis (DR-TB): A Systematic Review

Abstract

Objective: Bedaquiline is recommended by World Health Organization (WHO) to treat Drug-Resistant Tuberculosis (DR-TB). Bedaquiline is chosen due to its efficacy and safety in numerous studies. One adverse event that could happen is QT interval prolongation, which increases the risk of Torsade de Pointes (TdP) and leads to death. This study aimed to discuss the knowledge on the effect of bedaquiline on before-after and changes of QT interval. Materials and Methods: This systematic review based on PRISMA guidelines through PubMed, Cochrane, Science Direct, ProQuest, Google Scholar, and Epistemonikos until April 10, 2023. The keywords used was (“Bedaquiline” AND “QT Interval”).  We implemented inclusion and exclusion criteria by PICOS framework then assessed the studies by Joanna Briggs Institute (JBI) critical appraisal checklist tools. Results: From 1.170 articles, eleven articles met the criteria. In total 2449 patients assessed in this study. Most of the studies carried out treatment duration of 6 months. There was a change in the mean QT interval between 11ms to 52.5ms in patients using bedaquiline from the beginning to the end of treatment. The mean QT interval after treatment ranges from 409.7ms – 464.5ms. Conclusion: The use of bedaquiline requires attention to the ECG before and during therapy. Regular monitoring is necessary to prevent QT prolongation.