{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T06:20:16Z","timestamp":1770790816484,"version":"3.50.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005205","name":"Janssen Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005205","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002992","name":"Department for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002992","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Treatment of rifampicin-resistant tuberculosis (RR-TB) involves drugs that can prolong the QT interval. There is limited data on risk factors and the level of cardiac monitoring required. We analysed STREAM Stage 2 data to address these issues. A post-hoc analysis was undertaken of data from participants allocated to 3 regimens: 9-month control (n\u2009=\u2009202), 9-month oral (n\u2009=\u2009211) and 6-month (n\u2009=\u2009143). Risk factors for development of a QT or QTcF (corrected QT interval [Fredericia\u2019s formula]) interval \u2265500ms were assessed. The diagnostic accuracy of a monitoring strategy for QT\/QTcF prolongation was tested. QT\/QTcF\u2009\u2265\u2009500ms occurred on all regimens: 9-month control (n\u2009=\u200914 (6.9%)), 9-month oral (n\u2009=\u20098 (3.8%)) and 6-month (n\u2009=\u20096 (4.2%)). The participating country with the highest number of QT\/QTcF interval \u2265500ms events was Mongolia (18 events [64%]). A higher baseline QTcF was significantly associated with development of QT\/QTcF\u2009\u2265\u2009500ms (OR 1.05; 95% CI 1.03 to 1.07, p\u2009&lt;\u20090.001). There was a suggested association between moxifloxacin (compared to levofloxacin, OR 2.49; 95% CI 0.92 to 6.71, p\u2009=\u20090.07) and a higher baseline TSH (OR 3.52; 95% CI 0.84 to 14.73, p\u2009=\u20090.08) and increased odds of QT\/QTcF\u2009\u2265\u2009500ms. The monitoring strategy performed well in the control (sensitivity 100%; specificity 62%; positive predictive value (PPV) 13% and negative predictive value (NPV) 100%) and oral (sensitivity 100%, specificity 59%, PPV 6% and NPV 100%) regimen groups. Baseline QTcF and geographical region were associated with increased odds of QT\/QTcF prolongation. The monitoring strategy performed well in the identification of participants at higher risk of QT\/QTcF prolongation.<\/jats:p>","DOI":"10.1371\/journal.pgph.0005113","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:32:06Z","timestamp":1770748326000},"page":"e0005113","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["QT prolongation risk factors and a monitoring strategy in rifampicin-resistant tuberculosis: Findings from the STREAM Stage 2 trial"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1802-5381","authenticated-orcid":true,"given":"Gareth","family":"Hughes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5978-292X","authenticated-orcid":true,"given":"Elena","family":"Frangou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Bern","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meera","family":"Gurumurthy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bazarragchaa","family":"Tsogt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9291-2490","authenticated-orcid":true,"given":"Chen-Yuan","family":"Chiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9158-4595","authenticated-orcid":true,"given":"Andrew J.","family":"Nunn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah K.","family":"Meredith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth L.","family":"Goodall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"STREAM Trial Collaboration","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"pgph.0005113.ref001","volume-title":"WHO consolidated guidelines on tuberculosis. 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