Symptoms and Systemic Drug Reactions in Persons Receiving Weekly Rifapentine Plus Isoniazid (3HP) Treatment for Latent Tuberculosis Infection
Por:
Sadowski, C, Belknap, R, Holland, DP, Moro, RN, Chen, MP, Wright, A, Millet, JP, Cayla, JA, Scott, NA, Borisov, A, Gandhi, NR
Publicada:
23 feb 2023
Ahead of Print:
1 feb 2023
Resumen:
Background Three months of weekly rifapentine plus isoniazid (3HP) therapy for latent tuberculosis infection (LTBI) is recommended worldwide. The development of symptoms and systemic drug reactions (SDRs) on 3HP have not been fully characterized. We aimed to determine the patterns of symptom development and identify SDRs and associated factors in patients taking 3HP. Methods We analyzed symptoms data in participants receiving 3HP in the Tuberculosis Trials Consortium's iAdhere study (Study 33). We examined the patterns of symptom reporting across participants from baseline and 4 monthly visits. Bivariate analyses and multivariable regression models were used to identify factors associated with SDRs. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Results Among 1002 participants receiving 3HP, 768 (77%) reported at least 1 symptom; 97% of these symptoms were grade 1 (79%) or grade 2 (18%). Most symptoms developed in the first month and resolved. A total of 111 (11%) participants had symptoms that met criteria for SDRs; however, 53 (48%) of these participants completed therapy. Factors associated with SDRs and discontinuation included female sex (RR: 2.05; 95% CI: 1.19-3.54), age >= 45 years (RR: 1.99; 95% CI: 1.19-3.31), and use of concomitant medications (RR: 2.26; 95% CI: 1.15-4.42). Conclusions Although most patients receiving 3HP reported symptoms, most were mild, occurred early, and resolved without stopping treatment. Among patients experiencing SDRs, nearly half were able to complete therapy. Patient and provider education should focus on differentiating severe reactions where 3HP should be stopped from minor symptoms that will resolve.
We found that patients commonly reported symptoms while receiving 3-month daily rifapentine plus isoniazid for latent tuberculosis infection, which were typically mild and resolved on their own. Systemic drug reactions occurred but did not always lead to discontinuation of treatment.
Filiaciones:
Sadowski, C:
Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA USA
US Ctr Dis Control & Prevent, Clin Res Branch, Div TB Eliminat, Natl Ctr HIV Viral Hepatitis STD & TB Prevent NCH, Atlanta, GA USA
Oak Ridge Inst Sci & Educ, Oak Ridge, TN USA
Belknap, R:
Denver Publ Hlth, Denver Metro TB Program, Denver, CO USA
Holland, DP:
Emory Univ, Dept Med, Div Infect Dis, Atlanta, GA USA
Moro, RN:
CDC Fdn, Res Collaborat, Atlanta, GA USA
US Ctr Dis Control & Prevent, Div Healthcare Qual Promot, Natl Ctr Emerging & Zoonot Infect Dis NCEZID, Atlanta, GA USA
Chen, MP:
US Ctr Dis Control & Prevent, Immunizat Serv Div, Natl Ctr Immunizat & Resp Dis NCIRD, Atlanta, GA USA
Wright, A:
Vanderbilt Univ, Div Infect Dis, Med Ctr, Nashville, TN USA
Millet, JP:
Publ Hlth Agcy Barcelona, Epidemiol Serv, Barcelona, NE, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Fdn TB Res Unit Barcelona, Barcelona, Spain
Cayla, JA:
Fdn TB Res Unit Barcelona, Barcelona, Spain
Scott, NA:
US Ctr Dis Control & Prevent, Clin Res Branch, Div TB Eliminat, Natl Ctr HIV Viral Hepatitis STD & TB Prevent NCH, Atlanta, GA USA
Borisov, A:
US Ctr Dis Control & Prevent, Clin Res Branch, Div TB Eliminat, Natl Ctr HIV Viral Hepatitis STD & TB Prevent NCH, Atlanta, GA USA
Gandhi, NR:
Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA USA
hybrid, All Open Access, Hybrid Gold
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