New short regimens for latent tuberculosis treatment: safety first!

Menzies, Dick; Trajman, Anete

doi:10.1183/13993003.02180-2018

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…An RCT in 2015 found similar results [ 24 ], reporting female sex, elderly, low BMI, and a white race to be highly likely of developing side effects [ 23 ]. While safety should be the first consideration while choosing any regimen, extreme caution and monitoring are needed when using 3HP in the elderly population (aged 50-70 years), considering their vulnerability and immunocompromised status [ 25 ].…”

Section: Reviewmentioning

confidence: 99%

Use of Isoniazid Monotherapy in Comparison to Rifamycin-Based Regimen for the Treatment of Patients With Latent Tuberculosis: A Systematic Review

Shahid¹,

Naguit²,

Jakkoju³

et al. 2022

Cureus

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Tuberculosis (TB) is a common infectious disease that is present all around the world. This insidious disease needs drastic measures for its eradication. One of the actions contributing to it is the timely diagnosis and offering suitable treatment options for latent tuberculosis patients. In this review, we will discuss and compare the variety of options available for this purpose. We searched PubMed/Medline, Cochrane library, Google Scholar, and Science Direct to find articles regarding the effectiveness, safety, and completion of any of the five regimens available for latent tuberculosis infection. These options are the most classic and standard nine months of isoniazid given daily, which is now more commonly given as six months course, three months of daily isoniazid and rifampin, three months of weekly isoniazid and rifapentine, and four months of daily rifampin. We looked into free full-text studies published from 2011 to 2021 available in English language and human studies. After applying inclusion/exclusion criteria and removing duplicates and screening, 34 articles were shortlisted for quality assessment check, after which we finalized nine studies. Cochrane risk-of-bias assessment tool was used for quality check of randomized control trials, New-Castle Ottawa tool for observational studies, and assessment of multiple systematic reviews (AMSTAR) tool for systematic reviews. Efficacy was checked by tracking down the new cases of TB in the sample population that took the treatment for latent tuberculosis infection. New rifamycin-based regimens were almost equal in effectiveness to isoniazid regimens. The side effect profile is different for both regimens, but short-duration courses tend to have a higher chance of completion.

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Section: Reviewmentioning

confidence: 99%

Use of Isoniazid Monotherapy in Comparison to Rifamycin-Based Regimen for the Treatment of Patients With Latent Tuberculosis: A Systematic Review

Shahid¹,

Naguit²,

Jakkoju³

et al. 2022

Cureus

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“…Case holding until the completion of the prescribed treatment is a key issue (Alsdurf et al, 2016). The prescription of short regimens, mainly rifampicin-based, increases the adherence rate and decreases the need for clinical follow-up and the risk of adverse events (Abubakar et al, 2019;Menzies and Trajman, 2018).…”

Section: Screening and Management Of Ltbi: A Change In Paradigmmentioning

confidence: 99%

Is the EU model for contact investigation applicable to high TB burden settings?

Zellweger¹

2020

International Journal of Infectious Diseases

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Contact investigation is the search for secondary cases of tuberculosis (TB) or latent tuberculosis infection (LTBI) among contacts of patients with a transmissible form of TB, usually smear-positive pulmonary disease. The aim is to detect those who have already started developing TB in order to initiate treatment as soon as possible and prevent further transmission of the disease, and also to detect those who have been infected and could benefit from a preventive treatment before the development of TB. The implementation of preventive therapy for persons with the highest risk of developing TB, that is the reduction of the pool of future cases of TB, is now considered one of the activities able to support a decline in the prevalence of TB. This implies that the search for infected contacts and the prevention of TB should be performed in parallel with diagnostic and curative activities. The implementation of screening activities, at least for exposed children and immunocompromised persons, seems to be feasible without unaffordable costs, even in high TB burden settings.

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“…The rifapentine (RPT) plus INH regimen, which has been used with a weekly dose for three months for a total of 12 doses and recommended since 2011 by the CDC, has been evaluated in at least three randomized controlled trials 51 - 53 and in a meta-analysis, 54 showing to be as effective as INH monotherapy, with higher rates of treatment completion and less hepatotoxicity. However, recent research 55 , 56 with adults aged 50 to 70 years, who were randomized to receive one of two short regimens containing rifapentine (three months of RPT plus INH or two months of RPT 600 mg twice a week, plus INH 600 mg) had to be discontinued prematurely due to the high rate of adverse events. Although studies have methodological limitations, these findings raise concerns about the use of RPT more INH in older adults and require a more careful evaluation.…”

Section: Treatment Of Ltbimentioning

confidence: 99%

Latent tuberculosis infection in patients with rheumatic diseases

et al. 2019

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Most people infected by Mycobacterium tuberculosis (Mtb) do not have any signs or disease symptoms, a condition known as latent tuberculosis infection (LTBI). The introduction of biological agents, mainly tumor necrosis factor (TNF) inhibitors, for the treatment of immune-mediated diseases such as Rheumatoid Arthritis (RA) and other rheumatic diseases, increased the risk of reactivation of LTBI, leading to development of active TB. Thus, this review will approach the aspects related to LTBI in patients with rheumatologic diseases, especially those using iTNF drugs. For this purpose it will be considered the definition and prevalence of LTBI, mechanisms associated with diseases and medications in use, criteria for screening, diagnosis and treatment. Considering that reactivation of LTBI accounts for a large proportion of the incidence of active TB, adequate diagnosis and treatment are crucial, especially in high-risk groups such as patients with rheumatologic diseases.

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New short regimens for latent tuberculosis treatment: safety first!

Abstract: Safety must be the first consideration in evaluating any new regimen for latent tuberculosis treatment. Caution is needed when using isoniazid plus rifapentine, once or twice weekly, in individuals aged over 50 years, even for a short period.

Cited by 5 publications

References 18 publications

Use of Isoniazid Monotherapy in Comparison to Rifamycin-Based Regimen for the Treatment of Patients With Latent Tuberculosis: A Systematic Review

Use of Isoniazid Monotherapy in Comparison to Rifamycin-Based Regimen for the Treatment of Patients With Latent Tuberculosis: A Systematic Review

Is the EU model for contact investigation applicable to high TB burden settings?

Latent tuberculosis infection in patients with rheumatic diseases

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