Side effects due to primary antituberculosis drugs during the initial phase of therapy in 1149 hospitalized patients for tuberculosis

Gülbay, Banu Eriş; Gürkan, Özlem Ural; Yildiz, Öznur Akkoca; Önen, Zeynep Pınar; Erkekol, Ferda Öner; Baççıoğlu, Ayşe; Acican, Turan

doi:10.1016/j.rmed.2006.01.014

Cited by 134 publications

(118 citation statements)

References 24 publications

(58 reference statements)

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“…The present study reaffirmed a significantly higher risk of drug-induced hepatitis among older patients [1,2,4,6,7,13,15] although a few studies showed negative findings [5,11]. The present findings also corroborated a case-control study in Hong Kong that showed only age and hepatitis B infection were significantly related to anti-TB treatment [6], although the risk of drug-induced hepatitis due to chronic hepatitis B may have been over-estimated by assuming negative results for those with unknown HBsAg.…”

Section: Table 1 Continuedsupporting

confidence: 77%

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Standard anti-tuberculosis treatment and hepatotoxicity: do dosing schedules matter?

Chang

Leung²,

Yew³

et al. 2006

European Respiratory Journal

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A nested case-control study was conducted in order to examine whether dosing schedules of standard pyrazinamide-containing anti-tuberculosis (TB) treatment (standard treatment) might affect hepatotoxicity.The present authors retrospectively identified all patients with hepatitis using biochemical criteria from a cohort of 3,007 clinic patients who commenced anti-TB treatment from January 1 to June 30, 2001. Each case with hepatitis between 1-9 weeks post-TB treatment was compared using conditional logistic regression analysis with two controls selected randomly from patients without hepatitis in the same period and matched by sex, age and standard treatment. Impacts of sex and age were examined by logistic regression analysis of cases and patients without hepatitis.Hepatitis occurred in 167 patients, of whom 96 qualified as cases. A conditional logistic risk model identified hepatitis B surface antigen carriage as the only risk factor (odds ratio (95% confidence interval (CI)) 1.8 (1.1-3.1)). Logistic regression analysis showed that sex was nonsignificant but ageing increased the odds of hepatitis. The risk of hepatitis increased from 2.6% (1.9-3.5%) to 4.1% (3.2-5.3%) as age exceeded 49 yrs.Dosing schedules in the first 9 weeks have little impact on hepatotoxicity. If patients at risk of both hepatitis and relapse receive standard treatment, daily dosing is preferable.

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Section: Table 1 Continuedsupporting

confidence: 77%

“…isk factors for hepatitis have been evaluated by a number of observational studies [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] but few addressed treatment-related factors [12][13][14][15]. While the latter focused on the risk of hepatitis induced by individual drugs, the impact of dosing schedules has not been adequately addressed.…”

mentioning

confidence: 99%

Standard anti-tuberculosis treatment and hepatotoxicity: do dosing schedules matter?

Chang

Leung²,

Yew³

et al. 2006

European Respiratory Journal

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“…Incidence of hepatotoxicity was between 2.4-11.3 % in Turkish population (5,(18)(19)(20)(21). The high variance for hepatotoxicity among studies may be attributed to different patient groups as genetic factors play an important role in the development of hepatotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for hepatotoxicity in patients hospitalized for tuberculosis

et al. 2017

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Introduction:Combination therapy with four drugs (isoniazid, rifampicin, pyrazinamid and ethambutol) is the treatment of choice in tuberculosis but hepatotoxicity due to these drugs is an important medical concern. Therefore identification of patient groups with increased risk for antituberculosis therapy induced hepatotoxicity is crucial. Objective: To assess the rate of hepototoxicity due to antituberculosis drugs and to determine factors associated with hepatotoxicity in hospitalized tuberculosis patients. Methods: This retrospective cohort study included hospitalized patients with the diagnosis of tuberculosis during a ten year period. Only patients with microbiological (culture positive) or histopathological (presence of granulomatous reaction with caseification necrosis in the tissue) evidence of tuberculosis infection were included. Incidence of hepatotoxicity and the association of hepatotoxicity with known and unknown risk factors were investigated. Results: Sixty four patients (33 female-31 male; median age 48.0 years) were included into the study. Most of the patients had extrapulmonary tuberculosis (n=49). Antituberculosis therapy was started with four drugs in all patients and 7 patients developed hepatotoxicity. Age, gender, previous tuberculosis history, extent of tuberculosis, positive hepatitis B virus serology, diabetes mellitus and chronic renal insufficiency were not related with the development of hepatotoxicity. The presence of rheumatologic disease and chronic corticosteroid use was associated with increased risk of hepatotoxicity (p<0.01 and p=0.01, respectively). Conclusion:In this study we found that patients with rheumatologic diseases and patients on chronic corticosteroid treatment had increased risk for hepatotoxicity during antituberculosis therapy. These patients should be closely monitored for hepatotoxicity especially during the initial treatment phase.

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“…Serious side effects caused by tuberculosis treatment [18] leads to discontinuation of the treatment equally in patient infected with HIV and in patient who were not [19].…”

Section: Barrier In Treatment Completionmentioning

confidence: 99%

TB: Barrier in access, diagnosis and treatment completion

Marahatta

Shrestha

Bhattarai

et al. 2016

J. Manmohan Memorial Inst. Health. Sci.

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Tuberculosis (TB) is a major public health concern for Nepal like many other developing countries around the world. Economic barrier is one of the major problems in poor and marginalized population. Poor people mostly remain unaware of the treatment facilities and some find it difficult in seeking T.B treatment as they don’t trust the program and most of them don’t possess enough knowledge about the disease itself. Population residing in the remote areas of the countries can’t access the treatment facilities due to far distance of health facilities from there residence due to lack of roads and lack of transport. Thus difficult geography primarily in rural areas in the country acts as a barrier to access the health facility. TB infection faces add-on challenge with the advent of co-infection and possibility of increase in drug resistant TB. This is why detecting TB in its early stage would pose a number of advantages to the patient that would in turn help for early treatment. However, the challenges and barriers in early diagnosis remain that is being contributed by multifaceted factors. The lack of knowledge coupled with poor financial capacity to pay for the diagnosis especially in rural population prevents them from being diagnosed properly as well. Factors for not completing the treatment are when patient starts feeling better, lack of drugs, major side effects of the drugs and inadequate knowledge about advantages of completion of the drug treatment. The attitude of the hospital staff also in many cases leads to discontinuation of the treatment. Patient who have limited income and got financial support from their relatives explained about treatment going above their obtainable resources leading to early withdrawal from the treatment completion. Geography is one of the important issues for treatment completion as routine drug administration follow up in patient (farther from particular distance) is difficult and leads to exhaustion and withdrawal from the treatment.Journal of Manmohan Memorial Institute of Health Sciences Vol. 2 2016 p.76-80

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Side effects due to primary antituberculosis drugs during the initial phase of therapy in 1149 hospitalized patients for tuberculosis

Cited by 134 publications

References 24 publications

Standard anti-tuberculosis treatment and hepatotoxicity: do dosing schedules matter?

Standard anti-tuberculosis treatment and hepatotoxicity: do dosing schedules matter?

Risk factors for hepatotoxicity in patients hospitalized for tuberculosis

TB: Barrier in access, diagnosis and treatment completion

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