Impact of Age on Outcome of Rifapentine-Based Weekly Therapy for Latent Tuberculosis Infection
| Autor: | Hung-Ling Huang, Meng-Hsuan Cheng, Tun-Chieh Chen, Chun Kai Huang, Jann-Yuan Wang, Ping-Chang Lai, Inn-Wen Chong, Meng-Rui Lee, Po-Liang Lu, Chau-Chyun Sheu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty systemic drug reaction hypertension latent tuberculosis infection Population Antitubercular Agents 030204 cardiovascular system & hematology Logistic regression 03 medical and health sciences 0302 clinical medicine Latent Tuberculosis Internal medicine Completion rate medicine Isoniazid Humans Short course 030212 general & internal medicine education Online Only Articles Aged education.field_of_study Latent tuberculosis business.industry Middle Aged medicine.disease Rifapentine Discontinuation Major Articles and Commentaries rifapentine Infectious Diseases AcademicSubjects/MED00290 age Drug Therapy Combination Rifampin business medicine.drug |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background Weekly rifapentine and isoniazid (3HP) is gaining popularity for latent tuberculosis infection treatment because of its short course and high completion rate. Prior to widespread use, comprehensive 3HP treatment assessment covering an all-age population is essential. Methods Participants receiving ≥1 3HP dose from September 2014 to December 2019 were stratified into elderly (≥65 years), middle-aged (>35 & Results Overall, 134 of 579 (23.1%) participants were elderly. The completion rate was 83.1% overall and was highest and lowest in the younger group (94.5%) and elderly (73.9%) group, respectively. However, the 3HP discontinuation rate was not significantly different among the 3 groups in multivariate logistic regression analysis. In total, 362 (62.5%) participants experienced 1 or more adverse drug reactions (ADRs), of which 38 (10.5%) and 98 (27.1%) required temporary and permanent treatment interruption, respectively. The SDR risk was 11.2% in overall and 17.1% in the middle-aged group, 3.04-fold higher than that in the elderly group (P = .025). This finding was consistently observed in different clinical settings. Hypertensive events accompanied with flu-like symptoms occurred in 11.2% of elderly participants, and accounted for 50% of grade ≥3 ADRs. Conclusions With proper medical support and programmatic follow-up, the 3HP completion rate is >70% even in elderly participants. In middle-aged and elderly individuals, 3HP should be employed with caution because of risk of SDRs and hypertensive events, respectively. Summary: Under programmatic medical support, widespread use of weekly rifapentine and isoniazid (3HP) for latent tuberculosis treatment is possible for its high completion rate. 3HP should be employed with caution for risk of systemic drug reactions and hypertensive events in middle-aged and elderly individuals, respectively. |
| Databáze: | OpenAIRE |
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