Efficacy and safety of daily treatments for drug-susceptible pulmonary tuberculosis: a systematic review and network meta-analysis

• Tipo: Outra Publicação em Revista Científica Internacional
• Data: 2022

Autores

Imazu, P (Autor) Outra; Santos, JM (Autor) Outra; Beraldi-Magalhaes, F (Autor) Outra; Fernandez-Llimos, F (Autor) FFUP; Tonin, FS (Autor) Outra; Pontarolo, R (Autor) Outra

Revista

Título: Journal of Pharmacy and Pharmacology

Vol. 74

Páginas: 905-917

ISSN: 0022-3573

Editora: Oxford University Press

Indexação

ISI Web of Knowledge - 4 Citações

Scopus - 0 Citações

Outras Informações

ID Authenticus: P-00W-F2H

DOI: 10.1093/jpp/rgac004

Abstract (EN): Objectives To evaluate and update the evidence on the comparative efficacy and safety of antimicrobial drugs regimens for treating pulmonary drug-susceptible tuberculosis (DS-TB). Methods A systematic review was performed with searches in PubMed and Scopus (PROSPERO-CRD42019141463). We included randomised controlled trials comparing the effect of any antimicrobial regimen lasting at least 2 weeks. The outcomes of interest were culture conversion and incidence of adverse events. Bayesian network meta-analyses and surface under the cumulative ranking curve (SUCRA) analyses were performed. Results were reported as odds ratio with 95% credibility intervals. Key findings Fifteen studies were included the meta-analysis (n = 7560 patients). No regimen was statistically more effective than the WHO standard approach (rifampicin, isoniazid, ethambutol, and pyrazinamide). The use of rifapentine 450 mg instead of rifampicin in the standard regimen demonstrated to be statistically safer than all other options for serious adverse events (e.g. hepatotoxicity, arthralgia) (OR ranging from 0.0 [Crl 0.00-0.04] to 0.0 [0.00-0.97]; SUCRA probabilities of 10%). Therapies containing rifapentine (Rp1500HEZ, Rp900HEZ) and moxifloxacin (RMEZ, RHMZ) are effective regarding culture conversion, but statistical uncertainty on their safety profile exists. Conclusion The WHO standard regimen remains an overall effective and safe alternative for DS-TB. For intensive phase treatments, drugs combinations with rifapentine and moxifloxacin seem to reduce treatment duration while maintaining efficacy.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 13