Adjunctive vitamin D in tuberculosis treatment: meta-analysis of individual participant data
| Autor: | Anna P. Ralph, Thomas R. Ziegler, Christian Wejse, Nawal Salahuddin, Adrian R. Martineau, Rubhana Raqib, Davaasambuu Ganmaa, David A. Jolliffe, Peter Daley, M. Ahsanul Haq |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Tuberculosis Adolescent Antitubercular Agents Calcitriol receptor law.invention Sputum culture Young Adult 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Drug Resistance Multiple Bacterial Internal medicine medicine Vitamin D and neurology Humans 030212 general & internal medicine Vitamin D Adverse effect Tuberculosis Pulmonary Aged Randomized Controlled Trials as Topic Aged 80 and over medicine.diagnostic_test business.industry Incidence (epidemiology) Sputum Mycobacterium tuberculosis Middle Aged medicine.disease 030228 respiratory system Dietary Supplements Receptors Calcitriol Female medicine.symptom business |
| Zdroj: | Jolliffe, D A, Ganmaa, D, Wejse, C, Raqib, R, Haq, M A, Salahuddin, N, Daley, P K, Ralph, A P, Ziegler, T R & Martineau, A R 2019, ' Adjunctive vitamin D in tuberculosis treatment : Meta-analysis of individual participant data ', European Respiratory Journal, vol. 53, no. 3, 1802003 . https://doi.org/10.1183/13993003.02003-2018 |
| ISSN: | 1399-3003 0903-1936 |
| Popis: | Background: Randomised controlled trials of adjunctive vitamin D in pulmonary tuberculosis (TB) treatment have yielded conflicting results. Individual participant data meta-analysis could identify factors explaining this variation. Methods: We meta-analysed individual participant data from randomised controlled trials of vitamin D in patients receiving antimicrobial therapy for pulmonary TB. Primary outcome was time to sputum culture conversion. Secondary outcomes were time to sputum smear conversion, mean 8-week weight and incidence of adverse events. Pre-specified subgroup analyses were done according to baseline vitamin D status, age, sex, drug susceptibility, HIV status, extent of disease and vitamin D receptor genotype. Results: Individual participant data were obtained for 1850 participants in eight studies. Vitamin D did not influence time to sputum culture conversion overall (adjusted HR 1.06, 95% CI 0.91–1.23), but it did accelerate sputum culture conversion in participants with multidrug-resistant pulmonary TB (adjusted HR 13.44, 95% CI 2.96–60.90); no such effect was seen in those whose isolate was sensitive to rifampicin and/ or isoniazid (adjusted HR 1.02, 95% CI 0.88–1.19; p-value for interaction=0.02). Vitamin D accelerated sputum smear conversion overall (adjusted HR 1.15, 95% CI 1.01–1.31), but did not influence other secondary outcomes. Conclusions: Vitamin D did not influence time to sputum culture conversion overall, but it accelerated sputum culture conversion in patients with multidrug-resistant pulmonary TB. |
| Databáze: | OpenAIRE |
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