Risk factors associated with adverse reactions to antituberculosis drugs

Abstract

This review sought to identify the available scientific evidence on risk factors associated with adverse reactions to antituberculosis drugs. We performed a systematic review of studies published in the 1965-2012 period and indexed in the MEDLINE and LILACS databases. A total of 1,389 articles were initially selected. After reading their abstracts, we selected 85 studies. Of those 85 studies, 16 were included in the review. Risk factors for adverse reactions to antituberculosis drugs included age > 60 years, treatment regimens, alcoholism, anemia, and HIV co-infection, as well as sodium, iron, and albumin deficiency. Protective factors against hepatic adverse effects of antituberculosis drugs included being male (combined OR = 0.38; 95% CI: 0.20-0.72) and showing a rapid/intermediate N-acetyltransferase 2 acetylator phenotype (combined OR = 0.41; 95% CI: 0.18-0.90). There is evidence to support the need for management of adverse reactions to antituberculosis drugs at public health care facilities.

Adverse effects of anti-tuberculosis drugs on HepG2 cell bioenergetics

“…7 Collectively, there are toxicity concerns regarding the use of anti-TB drugs as either dual-drug combinations or as a four drug fixed-dose combination, with subjects ranging from asymptomatic elevation of liver enzymes to displaying severe hepatitis. [4][5][6][7][8][9][10][11][12][13][14]18 We show here that the anti-TB drugs RIF, INH, & PZA significantly reduce ATP levels in ubiquinone oxidoreductase) oxidizes NADH produced predominantly from the tricarboxylic acid (TCA) cycle, but also from β-oxidation of fatty acids. Two electrons are produced from NADH oxidation, and these are used to reduce ubiquinone to ubiquinol in the inner mitochondrial membrane, and initiate the supply of electrons to be passed through the ETC to reduce oxygen to water.…”

“…3 However, adverse drug reactions during TB treatment persist for which there are risk factors that include gender, age, malnutrition, coinfection with HIV, and liver functionality. 4 Specifically, anti-TB drug-induced hepatotoxicity during standard multidrug TB treatment has been reported, with incidence influenced by a similar set of risk factors. [4][5][6][7] However, patients with anti-TB drug-induced elevation of liver transaminase levels may still be F o r P e e r R e v i e w asymptomatic.…”

“…4 Specifically, anti-TB drug-induced hepatotoxicity during standard multidrug TB treatment has been reported, with incidence influenced by a similar set of risk factors. [4][5][6][7] However, patients with anti-TB drug-induced elevation of liver transaminase levels may still be F o r P e e r R e v i e w asymptomatic. 6,8 Of the anti-TB drugs prescribed: RIF, INH, and PZA are potentially hepatotoxic [9][10][11][12][13][14] , whereas no hepatotoxicity has been described for ethambutol.…”

Extensively Drug-Resistant Tuberculosis: Report and Literature Review on Two Cases Requiring Prolonged Treatment

“…Nowadays, the most common AADRs among MDR-TB patients are liver and kidney function damage, leucopenia, rash, decreased hearing, and psychosis, which are present in approximately 35% of the patients [19,20]. In addition, a systematic review of 1389 articles mentioned that the risk factors for the AADRs were age greater than 60 years, alcoholism, anemia, and sodium, iron, and albumin deficiency [21]. Interestingly, only the female patient evidenced AADRs, and they were not the most frequent ones, according to the international evidence.…”

Gambaran kadar bilirubin pasien tuberkulosis paru selama pengobatan di RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2012 – Desember 2014

“…Akan tetapi, penelitian lebih jauh mengenai variasi jenis kelamin dalam metabolisme obat dibutuhkan untuk menarik kesimpulan yang lebih definitif. 16 Walaupun dalam beberapa penelitian terbaru yang dilakukan seperti penelitian oleh Naqvi, dkk mendapatkan hasil dimana laki-laki lebih dominan menderita cedera hati imbas obat. 11 Berdasarkan kelompok umur, semakin bertambahnya usia maka semakin meningkat angka kejadian peningkatan kadar bilirubin total pada pasien dan semakin menurunnya angka kadar bilirubin total normal.…”