Extracorporeal treatments for isoniazid poisoning: Systematic review and recommendations from the EXTRIP workgroup

Autor: Mowry, James, Shepherd, Greene, Hoffman, Robert, Lavergne, Valery, Gosselin, Sophie, Nolin, Thomas, Vijayan, Anitha, Kielstein, Jan, Roberts, Darren, Ghannoum, Marc, Alhatali, Badria, Anseeuw, Kurt, Bird, Steven, Berling, Ingrid, Bouchard, Josée, Bunchman, Timothy, Calello, Diane, Chin, Paul, Doi, Kent, Galvao, Tais, Goldfarb, David, Hassanian, Hossein, Hoegberg, Lotte, Kallab, Siba, Kebede, Sofia, Lewington, Andrew, Li, Yi, Macedo, Etienne, Maclaren, Rob, Mégarbane, Bruno, Ostermann, Marlies, Peng, Ai, Roy, Jean‐philippe, Walsh, Steven, Wong, Anselm, Wood, David, Yates, Christopher
Přispěvatelé: Service de Réanimation Médicale et Toxicologique [Hôpital Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Extracorporeal Treatments in Poisoning workgroup: Badria Alhatali, Kurt Anseeuw, Steven Bird, Ingrid Berling, Josée Bouchard, Timothy E Bunchman, Diane P Calello, Paul K Chin, Kent Doi, Tais Galvao, David S Goldfarb, Hossein Hassanian, Lotte C Hoegberg, Siba Kallab, Sofia Kebede, Andrew Lewington, Yi Li, Etienne M Macedo, Rob MacLaren, Bruno Megarbane, Marlies E Ostermann, Ai Peng, Jean-Philippe Roy, Steven J Walsh, Anselm Wong, David M Wood, Christopher Yates, Mégarbane, Bruno
Rok vydání: 2021
Předmět:
0301 basic medicine
medicine.medical_specialty
medicine.medical_treatment
030106 microbiology
030204 cardiovascular system & hematology
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Extracorporeal
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Renal Dialysis
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Internal medicine
Isoniazid
medicine
Animals
Humans
Pharmacology (medical)
Dosing
Dialysis
[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases
[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases
business.industry
Poisoning
Pyridoxine
[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
[SDV.TOX] Life Sciences [q-bio]/Toxicology
Systematic review
[SDV.TOX]Life Sciences [q-bio]/Toxicology
Practice Guidelines as Topic
Cohort
[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases
[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Hemodialysis
business
medicine.drug
Zdroj: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 2021, 41 (5), pp.463-478. ⟨10.1002/phar.2519⟩
ISSN: 1875-9114
0277-0008
DOI: 10.1002/phar.2519
Popis: Isoniazid toxicity from self-poisoning or dosing errors remains common in regions of the world where tuberculosis is prevalent. Although the treatment of isoniazid poisoning is centered on supportive care and pyridoxine administration, extracorporeal treatments (ECTRs), such as hemodialysis, have been advocated to enhance elimination of isoniazid. No systematic reviews or evidence-based recommendations currently exist on the benefit of ECTRs for isoniazid poisoning. The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup systematically collected and rated the available evidence on the effect of and indications for ECTRs in cases of isoniazid poisoning. We conducted a systematic review of the literature, screened studies, extracted data on study characteristics, outcomes, and measurement characteristics, summarized findings, and formulated recommendations following published EXTRIP methods. Forty-three studies (two animal studies, 34 patient reports or patient series, and seven pharmacokinetic studies) met inclusion criteria. Toxicokinetic or pharmacokinetic analysis was available for 60 patients, most treated with hemodialysis (n = 38). The workgroup assessed isoniazid as "Moderately Dialyzable" by hemodialysis for patients with normal kidney function (quality of evidence = C) and "Dialyzable" by hemodialysis for patients with impaired kidney function (quality of evidence = A). Clinical data for ECTR in isoniazid poisoning were available for 40 patients. Mortality of the cohort was 12.5%. Historical controls who received modern standard care including appropriately dosed pyridoxine generally had excellent outcomes. No benefit could be extrapolated from ECTR, although there was evidence of added costs and harms related to the double lumen catheter insertion, the extracorporeal procedure itself, and the extracorporeal removal of pyridoxine. The EXTRIP workgroup suggests against performing ECTR in addition to standard care (weak recommendation, very low quality of evidence) in patients with isoniazid poisoning. If standard dose pyridoxine cannot be administered, we suggest performing ECTR only in patients with seizures refractory to GABAA receptor agonists (weak recommendation, very low quality of evidence).
Databáze: OpenAIRE
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