A experiência brasileira com a implementação do 4:1 dose fixa combinada para o tratamento da tuberculose

Zuim, Regina; Menezes, Alexandre; Trajman, Anete

doi:10.5123/s1679-49742014000300016

Cited by 3 publications

(1 citation statement)

References 3 publications

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“…In Brazil, the FDC containing rifampicin, isoniazid, pyrazinamide, and ethambutol (HRZE) has been available since 2009 produced by local laboratories through a Partnership for Productive Development Agreement [290]. In spite of the methodological limitations casting doubt on the findings [291], an interrupted time series evaluating patient outcomes with this FDC found no difference in treatment abandonment rates although there was a trend toward decreased cure rates [292].…”

Section: Tuberculosis (Tb)mentioning

confidence: 99%

Fixed dose drug combinations – are they pharmacoeconomically sound? Findings and implications especially for lower- and middle-income countries

Godman

McCabe

Leong

2020

Expert Review of Pharmacoeconomics & Outcomes Research

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Introduction: There are positive aspects regarding the prescribing of fixed dose combinations (FDCs) versus prescribing the medicines separately. However, these have to be balanced against concerns including increased costs and their irrationality in some cases. Consequently, there is a need to review their value among lower-and middle-income countries (LMICs) which have the greatest prevalence of both infectious and noninfectious diseases and issues of affordability. Areas covered: Review of potential advantages, disadvantages, cost-effectiveness, and availability of FDCs in high priority disease areas in LMICs and possible initiatives to enhance the prescribing of valued FDCs and limit their use where there are concerns with their value. Expert commentary: FDCs are valued across LMICs. Advantages include potentially improved response rates, reduced adverse reactions, increased adherence rates, and reduced costs. Concerns include increased chances of drug:drug interactions, reduced effectiveness, potential for imprecise diagnoses and higher unjustified prices. Overall certain FDCs including those for malaria, tuberculosis, and hypertension are valued and listed in the country's essential medicine lists, with initiatives needed to enhance their prescribing where currently low prescribing rates. Proposed initiatives include robust clinical and economic data to address the current paucity of pharmacoeconomic data. Irrational FDCs persists in some countries which are being addressed.

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Section: Tuberculosis (Tb)mentioning

confidence: 99%

Fixed dose drug combinations – are they pharmacoeconomically sound? Findings and implications especially for lower- and middle-income countries

Godman

McCabe

Leong

2020

Expert Review of Pharmacoeconomics & Outcomes Research

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Efficacy and safety of a four-drug fixed-dose combination regimen versus separate drugs for treatment of pulmonary tuberculosis: a systematic review and meta-analysis

Lima¹,

Silva

Magalhães

et al. 2017

Brazilian Journal of Microbiology

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IntroductionTuberculosis, particularly multi-drug-resistant tuberculosis, is a major cause of morbidity and mortality worldwide. To the best of our knowledge, however, no study to date has assessed the combined use of the four available drugs for tuberculosis treatment, which is an issue of great clinical relevance.ObjectiveTo determine whether the four-drug fixed-dose combination is safer or more effective than separate drugs for treatment of pulmonary tuberculosis.MethodsA systematic review of the literature was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsIn pooled results from five randomized controlled trials with 3502 patients across Africa, Asia, and Latin America, four-drug fixed-dose combination therapy was no better than separate drugs therapy in terms of culture conversion after 2 and 6 months of treatment. There were no significant differences between the groups in overall incidence of adverse effects. However, the meta-analytic measure (log odds ratio) revealed that separate drugs treatment had a 1.65 [exp (0.5) = 1.65] increased chance of gastrointestinal adverse effects compared to four-drug fixed-dose combination treatment.ConclusionsThe reviewed studies showed that four-drug fixed-dose combination therapy provides greater patient comfort by reducing the number of pills and the incidence of gastrointestinal adverse effects, as well as simplifying pharmaceutical management at all levels.

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Análise temporal e epidemiológica dos casos de tuberculose no Estado do Piauí, Brasil

Lima

Ferreira

Batista

et al. 2020

RSD

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Tuberculosis is a chronic infectious and transmissible disease. It is acquired by inhaling Mycobacterium tuberculosis, which is present in the air when an infected individual coughs, sneezes, or even talks and expels particles contaminated by this agent. It mainly affects the lungs, but can also affect the kidneys, bones and meninges. Thus, this study aimed to analyze the epidemiological situation of tuberculosis in the state of Piauí from 2014 to 2018. The variables analyzed were: age group, gender, race, confirmed cases by year of diagnosis, number of cases reported in the municipalities, type of entry, incidence rate, clinical form of TB, closure situation and associated comorbidities. The analysis was performed using the data provided by SINAN/DATASUS. The following results were obtained, 2018 was the year with the highest number of notifications (843), males were the most affected in all the years analyzed, the most common clinical form was pulmonary tuberculosis, the most prevalent comorbidities were alcoholism, smoking and diabetes, the most common type of entry was new; in the situation of entry the highest percentage was the cure, however, ignored/white obtained a higher number in 2018. In addition, the most affected age group was 40 to 50 years, followed by 20 to 39 years; the cities with the highest number of cases were Teresina and Parnaíba; however, the cities with the highest incidence were Bom Princípio, Parnaíba and Cocal de Telha; the highest incidence rate occurred in 2018, and finally, the brown race showed the highest number of cases.

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A experiência brasileira com a implementação do 4:1 dose fixa combinada para o tratamento da tuberculose

Cited by 3 publications

References 3 publications

Fixed dose drug combinations – are they pharmacoeconomically sound? Findings and implications especially for lower- and middle-income countries

Fixed dose drug combinations – are they pharmacoeconomically sound? Findings and implications especially for lower- and middle-income countries

Efficacy and safety of a four-drug fixed-dose combination regimen versus separate drugs for treatment of pulmonary tuberculosis: a systematic review and meta-analysis

Análise temporal e epidemiológica dos casos de tuberculose no Estado do Piauí, Brasil

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