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Hepatotoxicity, efficacy and completion rate between 3 months of isoniazid plus rifapentine and 9 months of isoniazid in treating latent tuberculosis infection: A systematic review and meta-analysis.
J Chin Med Assoc. 2021 11 01; 84(11):993-1000.JC

Abstract

BACKGROUND

The mainstay therapy for latent tuberculosis infection is a 9-month regimen of daily isoniazid (9H) and a 3-month regimen of 12 once-weekly doses of isoniazid and rifapentine (3HP). We performed this updated meta-analysis to compare hepatotoxicity, efficacy and completion rate between these two regimens.

METHODS

We searched all literature in the major medical databases using the subject search terms "isoniazid" and "rifapentine", and performed a systemic review and meta-analysis.

RESULTS

A total of 14 studies were eligible for the meta-analysis, which included 5600 (49%) patients who received the 3HP regimen and 5919 (51%) patients who received the 9H regimen. A total of 202 (2%) patients had a drug-induced liver injury (DILI) and 11 317 (98%) did not. The pooled odds ratio (OR) of DILI in the 3HP regimen was 0.18 (95% confidence interval [CI], 0.12-0.26; p < 0.0001), compared with the 9H regimen. This result remained consistent in subgroup analyses of ethnicity and study design. The 3HP regimen was superior to the 9H regimen in the prevention of active tuberculosis (OR, 0.38, 95% CI, 0.18-0.80, p = 0.01). Furthermore, the 3HP regimen was associated with a better completion rate than the 9H regimen (OR: 2.30, 95% CI, 2.10-2.53, p < 0.0001).

CONCLUSION

The 3HP regimen is superior to the 9H regimen, with less hepatotoxicity, and better efficacy and completion rate in treating latent tuberculosis infection.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, and National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, ROC.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

34747900

Citation

Tseng, Shao-Yu, et al. "Hepatotoxicity, Efficacy and Completion Rate Between 3 Months of Isoniazid Plus Rifapentine and 9 Months of Isoniazid in Treating Latent Tuberculosis Infection: a Systematic Review and Meta-analysis." Journal of the Chinese Medical Association : JCMA, vol. 84, no. 11, 2021, pp. 993-1000.
Tseng SY, Huang YS, Chang TE, et al. Hepatotoxicity, efficacy and completion rate between 3 months of isoniazid plus rifapentine and 9 months of isoniazid in treating latent tuberculosis infection: A systematic review and meta-analysis. J Chin Med Assoc. 2021;84(11):993-1000.
Tseng, S. Y., Huang, Y. S., Chang, T. E., Perng, C. L., & Huang, Y. H. (2021). Hepatotoxicity, efficacy and completion rate between 3 months of isoniazid plus rifapentine and 9 months of isoniazid in treating latent tuberculosis infection: A systematic review and meta-analysis. Journal of the Chinese Medical Association : JCMA, 84(11), 993-1000. https://doi.org/10.1097/JCMA.0000000000000605
Tseng SY, et al. Hepatotoxicity, Efficacy and Completion Rate Between 3 Months of Isoniazid Plus Rifapentine and 9 Months of Isoniazid in Treating Latent Tuberculosis Infection: a Systematic Review and Meta-analysis. J Chin Med Assoc. 2021 11 1;84(11):993-1000. PubMed PMID: 34747900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatotoxicity, efficacy and completion rate between 3 months of isoniazid plus rifapentine and 9 months of isoniazid in treating latent tuberculosis infection: A systematic review and meta-analysis. AU - Tseng,Shao-Yu, AU - Huang,Yi-Shin, AU - Chang,Tien-En, AU - Perng,Chin-Lin, AU - Huang,Yi-Hsiang, PY - 2021/11/8/entrez PY - 2021/11/9/pubmed PY - 2021/11/9/medline SP - 993 EP - 1000 JF - Journal of the Chinese Medical Association : JCMA JO - J Chin Med Assoc VL - 84 IS - 11 N2 - BACKGROUND: The mainstay therapy for latent tuberculosis infection is a 9-month regimen of daily isoniazid (9H) and a 3-month regimen of 12 once-weekly doses of isoniazid and rifapentine (3HP). We performed this updated meta-analysis to compare hepatotoxicity, efficacy and completion rate between these two regimens. METHODS: We searched all literature in the major medical databases using the subject search terms "isoniazid" and "rifapentine", and performed a systemic review and meta-analysis. RESULTS: A total of 14 studies were eligible for the meta-analysis, which included 5600 (49%) patients who received the 3HP regimen and 5919 (51%) patients who received the 9H regimen. A total of 202 (2%) patients had a drug-induced liver injury (DILI) and 11 317 (98%) did not. The pooled odds ratio (OR) of DILI in the 3HP regimen was 0.18 (95% confidence interval [CI], 0.12-0.26; p < 0.0001), compared with the 9H regimen. This result remained consistent in subgroup analyses of ethnicity and study design. The 3HP regimen was superior to the 9H regimen in the prevention of active tuberculosis (OR, 0.38, 95% CI, 0.18-0.80, p = 0.01). Furthermore, the 3HP regimen was associated with a better completion rate than the 9H regimen (OR: 2.30, 95% CI, 2.10-2.53, p < 0.0001). CONCLUSION: The 3HP regimen is superior to the 9H regimen, with less hepatotoxicity, and better efficacy and completion rate in treating latent tuberculosis infection. SN - 1728-7731 UR - https://www.unboundmedicine.com/medline/citation/34747900/Hepatotoxicity_efficacy_and_completion_rate_between_3_months_of_isoniazid_plus_rifapentine_and_9_months_of_isoniazid_in_treating_latent_tuberculosis_infection:_A_systematic_review_and_meta_analysis_ L2 - https://doi.org/10.1097/JCMA.0000000000000605 DB - PRIME DP - Unbound Medicine ER -