Pauta corta de isoniazida y rifampicina comparada con isoniazida para la infección latente de tuberculosis. Ensayo clínico aleatorizado

Geijo, María Paloma; Herranz, Carmen Rosa; Vañó, David Francès; García, Ángel J. i Joan Castaño; García, Montserrat; Dimas, José Francisco

doi:10.1157/13102264

Cited by 29 publications

(4 citation statements)

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“…A total of 35 publications describing 30 unique studies initially met eligibility criteria [5, 6, 20–52]. Totals of 16 studies ( n = 44,149) [5, 20, 21, 23, 26, 29, 31, 32, 37, 41–44, 46, 48, 49] and 14 studies ( n = 44,128) [5, 20, 26, 27, 29, 31–33, 37, 41–44, 46] studies were included in the efficacy and completion NMAs, respectively. Thirteen studies met eligibility criteria but were judged to be heterogeneous related to aspects of endpoint definition, overlap of patients enrolled, treatment comparisons (which did not align with the network structure), and differences in patient population [6, 23–25, 30, 34, 36, 39, 45, 47, 50–52]; a section of the review’s supplemental information (see Additional file 1) details these studies and their findings.…”

Section: Resultsmentioning

confidence: 99%

“…Amongst the 16 RCTs [5, 20, 21, 23, 26, 29, 31, 32, 37, 41–44, 46, 48, 49] ( n = 44,149) analyzed for efficacy, data from head-to-head trials were available for 21/36 (58.3%) of the possible pairwise comparisons in the network, with single studies informing several of the comparisons. Of the 14 RCTs ( n = 44,128) used for the NMA of completion [5, 20, 26, 27, 29, 31–33, 37, 41–44, 46], head-to-head trials were available for 30/66 (45.5%) of the possible pairwise comparisons. The criteria used across studies to meet the endpoint of regimen completion ranged between 80 and 100% for the primary analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies used a combination of urinary testing, patient self-report and pill counts [20, 37, 42]. An additional 5 studies also used pill counts alone or combined with self-report [29, 32, 44, 46, 52]. One study compared directly observed to self-administered INH/RPT-3 with compliance to the latter assessed by self-report [52].…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses

et al. 2017

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BackgroundWe conducted a systematic review and network meta-analysis (NMA) to examine the efficacy and completion rates of treatments for latent tuberculosis infection (LTBI). While a previous review found newer, short-duration regimens to be effective, several included studies did not confirm LTBI, and analyses did not account for variable follow-up or assess completion.MethodsWe searched MEDLINE, Embase, CENTRAL, PubMed, and additional sources to identify RCTs in patients with confirmed LTBI that involved a regimen of interest and reported on efficacy or completion. Regimens of interest included isoniazid (INH) with rifapentine once weekly for 12 weeks (INH/RPT-3), 6 and 9 months of daily INH (INH-6; INH-9), 3–4 months daily INH plus rifampicin (INH/RFMP 3–4), and 4 months daily rifampicin alone (RFMP-4). NMAs were performed to compare regimens for both endpoints.ResultsSixteen RCTs (n = 44,149) and 14 RCTs (n = 44,128) were included in analyses of efficacy and completion. Studies were published between 1968 and 2015, and there was diversity in patient age and comorbidities. All regimens of interest except INH-9 showed significant benefits in preventing active TB compared to placebo. Comparisons between active regimens did not reveal significant differences. While definitions of regimen completion varied across studies, regimens of 3–4 months were associated with a greater likelihood of adequate completion.ConclusionsMost of the active regimens showed an ability to reduce the risk of active TB relative to no treatment, however important differences between active regimens were not found. Shorter rifamycin-based regimens may offer comparable benefits to longer INH regimens. Regimens of 3–4 months duration are more likely to be completed than longer regimens.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2377-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses

et al. 2017

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“…Hence, drug-drug interactions should be monitored. Three months of daily INH plus rifampin has also been approved for LTBI therapy [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Latent Tuberculosis Infection Among Rheumatology Patients and Management Practices in the United Arab Emirates: A Single-Center Retrospective Cohort Study

Al Nokhatha,

AlKindi,

Alfalasi

et al. 2023

Cureus

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Introduction Prior to immunosuppression, rheumatology patients are routinely screened for latent tuberculosis (TB) infection using interferon-gamma release assays (IGRAs). Variability in the management of latent and indeterminate IGRA results across institutions limited long-term outcome data. A retrospective study was conducted at Tawam Hospital, United Arab Emirates, to investigate the incidence and management protocols associated with positive and indeterminate IGRA results, as well as TB infection, among patients with rheumatic conditions. Methods A single-center retrospective observational study was performed at Tawam Hospital, Abu Dhabi, UAE. Ethical approval for this study was obtained from the Tawam Human Research Ethics Committee. Laboratory records and the hospital's electronic medical system were used to obtain information about IGRA results over a 12-year period (April 2010-April 2022). The hospital's electronic medical system was used to obtain patient information and subsequent management approaches of positive and indeterminate IGRAs. Moreover, long-term follow-up data were collected to determine the risk of TB reactivation in the cohort. Results We found a total of 1,012 positive and 223 indeterminate IGRA test results within the 12-year period. Within the rheumatology department, 123 positive and 39 indeterminate IGRA results were identified. In the indeterminate IGRA group, the majority were women (n = 24, 61.5%) and UAE nationals (n = 22, 56.4%), and their mean age was 38.6 years. Systemic lupus erythematosus was the most prevalent rheumatologic condition (n = 21, 53.8%). Thirteen (33.3%) were on disease-modifying anti-rheumatic drugs (DMARDs) and 26 (66.7%) were on corticosteroids during IGRA testing. A total of eight patients (20.5%) received anti-TB medications. In the positive IGRA group, the mean age was 55.7 years and the female-to-male ratio was 3:1. The most common rheumatologic condition was rheumatoid arthritis (n = 69, 56%). Sixty-five (52.8%) patients were on conventional DMARDs, 43 (34.9%) were on corticosteroids during IGRA testing, and 74 (60%) received anti-TB medications. Two cases (1.6%) of active TB infections were detected among patients with positive IGRA tests, both of whom were receiving anti-tumor necrosis factor alpha inhibitor treatment in combination with methotrexate. No cases of active TB infection were observed in the indeterminate IGRA group. Conclusion Long-term data on the risk of TB activation in positive and indeterminate IGRA results for rheumatological conditions are low. It is recommended to reassess the choice of using anti-TNF-α, with a positive IGRA result if no other feasible alternatives can be offered. Our findings stress the importance of age, underlying diseases, and immunosuppressive treatments in interpreting IGRA results and guiding patient management. A large multicenter study is needed to understand the differences and outcomes of such patients in TB endemic and ...

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A systematic review of adverse events of rifapentine and isoniazid compared to other treatments for latent tuberculosis infection

Pease

Hutton

Yazdi

et al. 2018

Pharmacoepidemiology and Drug

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Pauta corta de isoniazida y rifampicina comparada con isoniazida para la infección latente de tuberculosis. Ensayo clínico aleatorizado

Cited by 29 publications

References 16 publications

Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses

Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses

Prevalence of Latent Tuberculosis Infection Among Rheumatology Patients and Management Practices in the United Arab Emirates: A Single-Center Retrospective Cohort Study

A systematic review of adverse events of rifapentine and isoniazid compared to other treatments for latent tuberculosis infection

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