Isoniazid-Rifapentine for Latent Tuberculosis Infection: A Systematic Review and Meta-analysis

Njie, Gibril J.; Morris, Sapna Bamrah; Woodruff, Rachel Yelk; Moro, Ruth N.; Vernon, Andrew; Borisov, Andrey S.

doi:10.1016/j.amepre.2018.04.030

Cited by 59 publications

(46 citation statements)

References 32 publications

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“…Shorter rifamycin‐based regimens (e.g. weekly rifapentine plus isoniazid for 12 weeks and daily rifampicin for 4 months) are proving safe and effective alternatives to 9 months of isoniazid, especially in terms of lower risk of hepatotoxicity. However, the risks of other adverse effects (e.g.…”

Section: Tuberculosismentioning

confidence: 99%

See 1 more Smart Citation

Contemporary Concise Review 2018: Respiratory infections and tuberculosis

Hui

Leung

2019

Respirology

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Section: Tuberculosismentioning

confidence: 99%

“…However, the risks of other adverse effects (e.g. systemic or hypersensitivity reactions to rifamycins) remain considerable relative to the number of TB cases averted. A targeted approach is therefore necessary to optimize the benefit versus risk ratio at the expense of reduced population coverage .…”

Section: Tuberculosismentioning

confidence: 99%

Contemporary Concise Review 2018: Respiratory infections and tuberculosis

Hui

Leung

2019

Respirology

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“…For rifampin and rifapentine, plasma exposures higher than those achieved with current doses result in improved antituberculosis activity and appear to be relatively safe. Recent and ongoing clinical studies are likely to broadly redefine the optimal dosing strategies for these rifamycins and other drugs in treatment and preventive therapy regimens [19][20][21][22][23][24]. Evidence is needed to inform appropriate doses for tuberculosis at sites where penetration of the drugs into the diseased compartments is limited such as tuberculous pericarditis and tuberculous meningitis [25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Current research toward optimizing dosing of first-line antituberculosis treatment

McIlleron

Chirehwa

2018

Expert Review of Anti-infective Therapy

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Introduction: Drug concentrations in tuberculosis patients on standard regimens vary widely with clinically important consequences.Areas covered: We review the available literature identifying factors correlated with pharmacokinetic variability of antituberculosis drugs. Based on population pharmacokinetic models and the weight, height, and sex distributions in a large data base of African tuberculosis patients, we propose simplified weight-based doses of the available fixed dose combination(FDC) for adults with drug susceptible tuberculosis. Emerging studies will support optimized weight-based dosing for children. Other sources of important pharmacokinetic variability include genetic variants, drug-drug interactions, formulation quality, and methods of preparation and administration.Expert commentary: Optimized weight band-based dosing will result in more equitable distribution of drug exposures by weight. The use of high doses of isoniazid in patients with drug-resistant tuberculosis would be safer and more effective if a feasible test was developed to allow stratified dosing according to acetylator type. There is an urgent need for more suitable formulations of many second-line drugs for children. The adoption of new technologies and efficient FDC design may allow further advances for patients and treatment programs. Lastly, current efforts to ensure adequate quality of antituberculosis drug products are not preventing the use of substandard products to treat patients with tuberculosis.

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“…In the case of INH, despite occurring quite commonly, the considerable majority are low grade, transient and do not influence treatment adherence and completion . A recent meta‐analysis demonstrated that the three‐month isoniazid‐rifapentine regimen was associated with similar risk of adverse events and treatment discontinuation than other latent tuberculosis infection regimens . Regarding drug‐drug interactions (DDI) between TPT regimes and the existing ART, there are still some knowledge gaps to cover, such as co‐administration of TAF with any rifamycin, or use of 1HP with DTG.…”

Section: Discussionmentioning

confidence: 99%

New opportunities in tuberculosis prevention: implications for people living with HIV

et al. 2020

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Introduction Tuberculosis (TB) is a leading cause of mortality among people living with HIV (PLHIV). An invigorated global END TB Strategy seeks to increase efforts in scaling up TB preventive therapy (TPT) as a central intervention for HIV programmes in an effort to contribute to a 90% reduction in TB incidence and 95% reduction in mortality by 2035. TPT in PLHIV should be part of a comprehensive approach to reduce TB transmission, illness and death that also includes TB active case‐finding and prompt, effective and timely initiation of anti‐TB therapy among PLHIV. However, the use and implementation of preventive strategies has remained deplorably inadequate and today TB prevention among PLHIV has become an urgent priority globally. Discussion We present a summary of the current and novel TPT regimens, including current evidence of use with antiretroviral regimens (ART). We review challenges and opportunities to scale‐up TB prevention within HIV programmes, including the use of differentiated care approaches and demand creation for effective TB/HIV services delivery. TB preventive vaccines and diagnostics, including optimal algorithms, while important topics, are outside of the focus of this commentary. Conclusions A number of new tools and strategies to make TPT a standard of care in HIV programmes have become available. The new TPT regimens are safe and effective and can be used with current ART, with attention being paid to potential drug‐drug interactions between rifamycins and some classes of antiretrovirals. More research and development is needed to optimize TPT for small children, pregnant women and drug‐resistant TB (DR‐TB). Effective programmatic scale‐up can be supported through context‐adapted demand creation strategies and the inclusion of TPT in client‐centred services, such as differentiated service delivery (DSD) models. Robust collaboration between the HIV and TB programmes represents a unique opportunity to ensure that TB, a preventable and curable condition, is no longer the number one cause of death in PLHIV.

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Isoniazid-Rifapentine for Latent Tuberculosis Infection: A Systematic Review and Meta-analysis

Abstract: The 3-month isoniazid-rifapentine regimen is as safe and effective as other recommended latent tuberculosis infection regimens and achieves significantly higher treatment completion rates.

Cited by 59 publications

References 32 publications

Contemporary Concise Review 2018: Respiratory infections and tuberculosis

Contemporary Concise Review 2018: Respiratory infections and tuberculosis

Current research toward optimizing dosing of first-line antituberculosis treatment

New opportunities in tuberculosis prevention: implications for people living with HIV

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