Mycobacterium w Immunotherapy for Treating Pulmonary Tuberculosis - a Systematic Review

Author(s): Shaheen Pandie, Mark E. Engel, Zita S. Kerbelker, Bongani M. Mayosi.

Journal Name: Current Pharmaceutical Design

Volume 20 , Issue 39 , 2014

Abstract:

Background: Tuberculosis (TB) remains a global health catastrophe. Mycobacterium w is a heat-killed immune-modulating vaccine designed to attenuate the effects of TB, reduce time to sputum conversion, and thereby decrease transmission and improve cure rates.

Objectives: To evaluate Mycobacterium w (M w) immunotherapy as an adjunct to chemotherapy in participants with pulmonary TB (PTB).

Search strategy: In January 2012, we performed both a database search, a handsearch and corresponded with experts in the field.

Selection criteria: Randomised and quasi-randomised controlled trials of M w immunotherapy versus placebo (or no control) for participants with PTB.

Data collection and analysis: Two of the authors (SP and ZK) independently extracted data. Dichotomous outcomes were analysed using risk ratios (RR) and 95% confidence intervals (CI).

Outcomes: The primary outcome was to determine the effect of M w therapy on sputum conversion. Secondary outcomes were to determine the frequency of adverse reactions.

Main Results: Three trials (four papers) involving 368 participants were included. All four papers had methodological flaws. Overall, 173 participants received M w and 168 participants received placebo or no control. M w immunotherapy was effective at reducing time to sputum conversion at days 15 (RR 2.31; 95% CI 1.75 to 3.06; P < 0.001) and 30 (RR 1.83; 95% CI 1.12 to 2.98; P = 0.02). After day 30, benefit was only demonstrated in the category II TB (re-treatment).

Conclusions: The meta-analysis suggests benefit as regards the time to sputum conversion. The available data on M w immunotherapy for participants with PTB are however methodologically flawed. We advise that M w be investigated in a well-structured, randomised controlled trial.

Keywords: Tuberculosis, Mycobacterium w, immunotherapy.

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Article Details

VOLUME: 20
ISSUE: 39
Year: 2014
Page: [6207 - 6214]
Pages: 8
DOI: 10.2174/1381612820666140905150215
Price: $58

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