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

2022-03Journal article Open access
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dc.contributor.authorImazu, Priscila
dc.contributor.authorSantos, Josiane M.
dc.contributor.authorBeraldi-Magalhães, Francisco
dc.contributor.authorFernandez-Llimos, Fernando
dc.contributor.authorTonin, Fernanda
dc.contributor.authorPontarolo, Roberto
dc.date.accessioned2022-04-18T16:06:11Z
dc.date.available2022-04-18T16:06:11Z
dc.date.issued2022-03
dc.description.abstractObjectives: 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 in 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationImazu P, Santos JM, Beraldi-Magalhães F, Fernandez-Llimos F, Tonin FS, Pontarolo R. Efficacy and safety of daily treatments for drug-susceptible pulmonary tuberculosis: a systematic review and network meta-analysis. J Pharm Pharmacol. 2022;74(6):905-17.pt_PT
dc.identifier.doi10.1093/jpp/rgac004pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/14564
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford Academicpt_PT
dc.relation.publisherversionhttps://academic.oup.com/jpp/article-abstract/74/6/905/6556348?redirectedFrom=fulltextpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectAntitubercular agentspt_PT
dc.subjectDrug-susceptiblept_PT
dc.subjectNetwork meta-analysispt_PT
dc.subjectSystematic reviewpt_PT
dc.subjectTuberculosispt_PT
dc.titleEfficacy and safety of daily treatments for drug-susceptible pulmonary tuberculosis: a systematic review and network meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage917pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage905pt_PT
oaire.citation.titleJournal of Pharmacy and Pharmacologypt_PT
oaire.citation.volume74pt_PT
person.familyNameFernandez-Llimos
person.familyNameTonin
person.givenNameFernando
person.givenNameFernanda
person.identifierB-8931-2008
person.identifier.ciencia-idF716-B3AD-341A
person.identifier.ciencia-idD01C-C700-9411
person.identifier.orcid0000-0002-8529-9595
person.identifier.orcid0000-0003-4262-8608
person.identifier.ridO-2050-2017
person.identifier.scopus-author-id56085115800
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationffddaa12-a4fa-4aeb-b84a-0c36015a7d9c
relation.isAuthorOfPublication61ded30e-ecec-4b3e-b953-2293e080ebdd
relation.isAuthorOfPublication.latestForDiscoveryffddaa12-a4fa-4aeb-b84a-0c36015a7d9c

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