Cost-effectiveness of rifampin for 4 months and isoniazid for 6 months in the treatment of tuberculosis infection

Pina, Jaime; Clotet, L.; Ferrer, Anna; Sala, M.; Garrido, P.; Salleras, L.; Domı́nguez, Àngela

doi:10.1016/j.rmed.2013.01.017

Cited by 8 publications

(12 citation statements)

References 18 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of the included studies (n = 49) did not specify patient profiles 24 - 33 , 35 - 37 , 40 - 44 , 47 , 49 , 51 , 52 , 54 , 55 , 57 - 59 , 60 , 63 - 65 , 67 , 68 , 70 , 71 , 77 , 79 , 81 - 87 , 89 , 90 , 93 , 94 , four studies involved patients with inflammatory bowel disease or immune-mediated inflammatory diseases 72 , 73 , 76 , 80 , four involved human immunodeficiency virus (HIV)-positive adults 56 , 61 , 74 , 91 , four involved patients who transplanted or had transplants 34 , 50 , 62 , 66 , and six involved health professionals 38 , 39 , 45 , 48 , 78 , 88 .…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the various treatment alternatives for LTBI globally, among the studies analyzed, 53 used INH for 9 months 24 - 28 , 30 - 34 , 38 - 46 , 49 - 54 , 58 , 61 , 63 , 64 , 67 , 69 , 72 - 74 , 76 , 77 - 79 , 80 , 81 , 82 - 87 , 89 , 91 , 92 , 94 , 95 , 40 used INH for 6 months 24 , 26 , 27 , 29 , 34 - 36 , 39 , 42 - 44 , 47 - 49 , 53 , 55 , 56 , 57 , 59 - 62 , 64 , 65 , 67 , 68 , 70 , 71 , 72 , 74 , 75 , 84 , 86 - 90 , 93 , 94 , 95 , and two used INH for 12 months 66 . Rifampicin monothera...…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Isoniazid use, effectiveness, and safety for treatment of latent tuberculosis infection: a systematic review

Sodré-Alves,

Toledo,

Zimmermann

et al. 2024

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

Background: The treatment strategy for latent tuberculosis infection is to reduce the number of tuberculosis cases and consequently reduce the transmission of pathogenic bacteria. This study aimed to determine the safety, effectiveness, and adherence of isoniazid use for latent tuberculosis infection treatment. Methods: To identify studies on isoniazid use for latent tuberculosis infection, five electronic databases were searched. The methods and results are presented in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Most studies (53) used isoniazid for 9 months. The prevalence of use and adherence to treatment varied considerably (18% to 100%), and were evaluated by participant completion of isoniazid treatment for latent tuberculosis infection. The adverse events most frequently reported were hepatotoxicity, gastric intolerance, and neuropathy; the rates of occurrence ranged from < 1% to 48%. In the studies that evaluated the effectiveness of isoniazid for latent tuberculosis infection, the rate varied from 0 to 19.7% for patients who did not have active tuberculosis after the follow-up period. Conclusions: The importance of maintaining follow up for patients using isoniazid should be emphasized due to the risk of developing adverse events. Despite the treatment challenges, the rates of patients who used isoniazid and developed active tuberculosis during the follow-up period were low. We believe that isoniazid continues to contribute to tuberculosis control worldwide, and better care strategies are required.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Isoniazid use, effectiveness, and safety for treatment of latent tuberculosis infection: a systematic review

Sodré-Alves,

Toledo,

Zimmermann

et al. 2024

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

show abstract

“…Several large-scale studies have indicated that the efficacy of 3-month rifapentine/isoniazid regimen was similar to that of 9-month isoniazid or 4-month rifampin regimen. [21–23] Therefore, despite those studies might be accurate in stating that the 9-month isoniazid treatment method is the most economical regimen, they fail to consider the labor costs of DOTS. In Taiwan, DOTS visit LTBI patients 5 days a week for 9 months and spend approximately an hour with each patient.…”

Section: Discussionmentioning

confidence: 99%

Impacts of 12-dose regimen for latent tuberculosis infection

et al. 2016

View full text Add to dashboard Cite

Treatment of latent tuberculosis infection (LTBI) is essential for eradicating tuberculosis (TB). Moreover, the patient adherence is crucial in determining the effectiveness of TB control. Isoniazid given by DOTS daily for 9 months (9H) is the standard treatment for LTBI in Taiwan. However, the completion rate is low due to the long treatment period and its side effects. The combined regimen using a high dose of rifapentine/isoniazid once weekly for 12 weeks (3HP) has been used as an alternative treatment option for LTBI in the United States. This may result in a higher completion rate. In this pilot study, patient adherence and cost of these 2 treatment regimens were investigated. Thus, we aimed to assess the treatment completion rate and costs of 3HP and compare to those with 9H.Data from 691 cases of LTBI treatments including 590 cases using the conventional regimen and 101 cases with rifapentine/Isoniazid were collected. The cost was the sum of the cost of treatment with Isoniazid for 9 months or with rifapentin/Isoniazid for 3 months of all contacts. The effectiveness was the cost of cases of tuberculosis avoided.In this study, the treatment completion rate for patients prescribed with the 3 months rifapentine/isoniazid regimen (97.03%) was higher than those given the conventional 9-month isoniazid regimen (87.29%) (P <0.001). The cost of 3HP and 9H was US$261.24 and US$717.3, respectively. The cost-effectiveness ratio with isoniazid for 9 months was US$ 15392/avoided 1 case of tuberculosis and US$ 5225/avoided 1 case of tuberculosis with 3HP. In addition, when compared with the conventional regimen, there were fewer patients discontinued with rifapentine/isoniazid regimen due to undesirable side effects.This was the first study to compare the 2 treatment regimens in Taiwan, and it showed that a short-term high-dosage rifapentine/isoniazid treatment regimen reduced costs and resulted in higher treatment completion than the standard LTBI isoniazid treatment.

show abstract

“…Other regimens have also been found to be cost effective in certain settings. Pina et al compared 4R to 6H amongst TB contacts in Spain, finding that 4R is a more cost-effective TPT regimen compared to 6H (ICER EUR 8737.86 per averted TB case) [ 43 ]. 1HP has emerged more recently as a potential TPT regimen, and, as such, economic evidence to support its use and rollout is more limited.…”

Section: Tb Preventive Treatment (Tpt)mentioning

confidence: 99%

The Global Expansion of LTBI Screening and Treatment Programs: Exploring Gaps in the Supporting Economic Evidence

Kota¹,

Shrestha

Kashkary

et al. 2023

Pathogens

View full text Add to dashboard Cite

The global burden of latent TB infection (LTBI) and the progression of LTBI to active TB disease are important drivers of ongoing TB incidence. Addressing LTBI through screening and TB preventive treatment (TPT) is critical in order to end the TB epidemic by 2035. Given the limited resources available to health ministries around the world in the fight against TB, we must consider economic evidence for LTBI screening and treatment strategies to ensure that limited resources are used to achieve the biggest health impact. In this narrative review, we explore key economic evidence around LTBI screening and TPT strategies in different populations to summarize our current understanding and highlight gaps in existing knowledge. When considering economic evidence supporting LTBI screening or evaluating different testing approaches, a disproportionate number of economic studies have been conducted in high-income countries (HICs), despite the vast majority of TB burden being borne in low- and middle-income countries (LMICs). Recent years have seen a temporal shift, with increasing data from low- and middle-income countries (LMICs), particularly with regard to targeting high-risk groups for TB prevention. While LTBI screening and prevention programs can come with extensive costs, targeting LTBI screening among high-risk populations, such as people living with HIV (PLHIV), children, household contacts (HHC) and immigrants from high-TB-burden countries, has been shown to consistently improve the cost effectiveness of screening programs. Further, the cost effectiveness of different LTBI screening algorithms and diagnostic approaches varies widely across settings, leading to different national TB screening policies. Novel shortened regimens for TPT have also consistently been shown to be cost effective across a range of settings. These economic evaluations highlight key implementation considerations such as the critical nature of ensuring high rates of adherence and completion, despite the costs associated with adherence programs not being routinely assessed and included. Digital and other adherence support approaches are now being assessed for their utility and cost effectiveness in conjunction with novel shortened TPT regimens, but more economic evidence is needed to understand the potential cost savings, particularly in settings where directly observed preventive therapy (DOPT) is routinely conducted. Despite the growth of the economic evidence base for LTBI screening and TPT recently, there are still significant gaps in the economic evidence around the scale-up and implementation of expanded LTBI screening and treatment programs, particularly among traditionally hard-to-reach populations.

show abstract

Cost-effectiveness of rifampin for 4 months and isoniazid for 6 months in the treatment of tuberculosis infection

Abstract: Rifampin for 4 months was more cost-effective than isoniazid for 6 months.

Cited by 8 publications

References 18 publications

Isoniazid use, effectiveness, and safety for treatment of latent tuberculosis infection: a systematic review

Isoniazid use, effectiveness, and safety for treatment of latent tuberculosis infection: a systematic review

Impacts of 12-dose regimen for latent tuberculosis infection

The Global Expansion of LTBI Screening and Treatment Programs: Exploring Gaps in the Supporting Economic Evidence

Contact Info

Product

Resources

About