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Higher Completion Rates With Self-administered Once-weekly Isoniazid-rifapentine Versus Daily Rifampin in Adults With Latent Tuberculosis.
Clin Infect Dis. 2021 11 02; 73(9):e3459-e3467.CI

Abstract

BACKGROUND

Treatment of latent tuberculosis (LTBI) is important for tuberculosis (TB) prevention, and short course rifamycin-based therapies are preferred. Once-weekly isoniazid-rifapentine by self-administered therapy (3HP-SAT) has never been compared with 4 months of daily rifampin (4R).

METHODS

Retrospective cohort study of adults ≥18 years of age initiating LTBI treatment with either 3HP-SAT or 4R in a United States (US)-based TB clinic between 11 April 2016 and 31 December 2018. We evaluated treatment completion through pharmacy fills and reviewed charts for reasons of noncompletion, including adverse events (AEs). The χ 2 test and a log-binomial multivariable model were used to compare treatment completion and AEs.

RESULTS

Five hundred sixty individuals (42%) initiated 3HP-SAT and 773 (58%) initiated 4R. Median age was 38, 55% were female, and 89% were born outside of the US. Among those aged 18-49 years, treatment completion with 3HP-SAT was 79% compared to 68% with 4R (adjusted risk ratio [aRR], 1.17 [95% CI, 1.17-1.27]; P < .0001). Among individuals aged ≥50 years, treatment completion with 3HP-SAT was 87% compared to 64% with 4R (aRR, 1.35 [95% CI, 1.19-1.52]; P < .0001). Compared to 4R, there was no difference in risk of AEs in the 18-49 age group (aRR, 0.93 [95% CI, .58-1.48]; P = .75). Reduced risk of AEs was noted among patients aged ≥50 years who received 3HP-SAT (aRR, 0.37 [95% CI, .16-.85]; P = .02).

CONCLUSIONS

3HP-SAT was associated with higher LTBI treatment completion and lower rates of AEs compared to 4R in individuals aged 50 and older. Expanding 3HP-SAT as an option for patients with LTBI may enhance TB prevention strategies in the US.

Authors+Show Affiliations

Denver Health and Hospital Authority, Denver Public Health, Denver, Colorado, USA. Division of Infectious Diseases, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado, USA.Denver Health and Hospital Authority, Denver Public Health, Denver, Colorado, USA.Division of Infectious Diseases, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado, USA. Division of Geriatric Medicine, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado, USA.Denver Health and Hospital Authority, Denver Public Health, Denver, Colorado, USA. Division of Infectious Diseases, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32915203

Citation

Haas, Michelle K., et al. "Higher Completion Rates With Self-administered Once-weekly Isoniazid-rifapentine Versus Daily Rifampin in Adults With Latent Tuberculosis." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 73, no. 9, 2021, pp. e3459-e3467.
Haas MK, Aiona K, Erlandson KM, et al. Higher Completion Rates With Self-administered Once-weekly Isoniazid-rifapentine Versus Daily Rifampin in Adults With Latent Tuberculosis. Clin Infect Dis. 2021;73(9):e3459-e3467.
Haas, M. K., Aiona, K., Erlandson, K. M., & Belknap, R. W. (2021). Higher Completion Rates With Self-administered Once-weekly Isoniazid-rifapentine Versus Daily Rifampin in Adults With Latent Tuberculosis. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 73(9), e3459-e3467. https://doi.org/10.1093/cid/ciaa1364
Haas MK, et al. Higher Completion Rates With Self-administered Once-weekly Isoniazid-rifapentine Versus Daily Rifampin in Adults With Latent Tuberculosis. Clin Infect Dis. 2021 11 2;73(9):e3459-e3467. PubMed PMID: 32915203.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Higher Completion Rates With Self-administered Once-weekly Isoniazid-rifapentine Versus Daily Rifampin in Adults With Latent Tuberculosis. AU - Haas,Michelle K, AU - Aiona,Kaylynn, AU - Erlandson,Kristine M, AU - Belknap,Robert W, PY - 2020/05/06/received PY - 2020/09/09/accepted PY - 2020/9/12/pubmed PY - 2021/11/11/medline PY - 2020/9/11/entrez KW - isoniazid KW - latent KW - rifampin KW - rifapentine KW - tuberculosis SP - e3459 EP - e3467 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 73 IS - 9 N2 - BACKGROUND: Treatment of latent tuberculosis (LTBI) is important for tuberculosis (TB) prevention, and short course rifamycin-based therapies are preferred. Once-weekly isoniazid-rifapentine by self-administered therapy (3HP-SAT) has never been compared with 4 months of daily rifampin (4R). METHODS: Retrospective cohort study of adults ≥18 years of age initiating LTBI treatment with either 3HP-SAT or 4R in a United States (US)-based TB clinic between 11 April 2016 and 31 December 2018. We evaluated treatment completion through pharmacy fills and reviewed charts for reasons of noncompletion, including adverse events (AEs). The χ 2 test and a log-binomial multivariable model were used to compare treatment completion and AEs. RESULTS: Five hundred sixty individuals (42%) initiated 3HP-SAT and 773 (58%) initiated 4R. Median age was 38, 55% were female, and 89% were born outside of the US. Among those aged 18-49 years, treatment completion with 3HP-SAT was 79% compared to 68% with 4R (adjusted risk ratio [aRR], 1.17 [95% CI, 1.17-1.27]; P < .0001). Among individuals aged ≥50 years, treatment completion with 3HP-SAT was 87% compared to 64% with 4R (aRR, 1.35 [95% CI, 1.19-1.52]; P < .0001). Compared to 4R, there was no difference in risk of AEs in the 18-49 age group (aRR, 0.93 [95% CI, .58-1.48]; P = .75). Reduced risk of AEs was noted among patients aged ≥50 years who received 3HP-SAT (aRR, 0.37 [95% CI, .16-.85]; P = .02). CONCLUSIONS: 3HP-SAT was associated with higher LTBI treatment completion and lower rates of AEs compared to 4R in individuals aged 50 and older. Expanding 3HP-SAT as an option for patients with LTBI may enhance TB prevention strategies in the US. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/32915203/Higher_Completion_Rates_With_Self_administered_Once_weekly_Isoniazid_rifapentine_Versus_Daily_Rifampin_in_Adults_With_Latent_Tuberculosis_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciaa1364 DB - PRIME DP - Unbound Medicine ER -