Completion and Adverse Drug Events of Latent Tuberculosis Infection Treatment in Patients Receiving Dialysis: Predictors and Impacts of Different Regimens in a Prospective Cohort Study
Journal
Antimicrobial agents and chemotherapy
Journal Volume
65
Journal Issue
3
Date Issued
2021
Author(s)
Feng, Jia-Yih
Wei, Yu-Feng
Chang, Chin-Hao
Wang, Ping-Huai
Abstract
Although patients with end-stage renal disease receiving maintenance hemodialysis are at high risk for tuberculosis, the optimal treatment regimen for latent tuberculosis infection (LTBI) in this group has scarcely been studied for predictors of completion rate and adverse drug events (ADE). We prospectively enrolled dialysis patients for LTBI intervention from three medical centers in Taiwan. LTBI treatments were 3 months of weekly rifapentine plus isoniazid (3HP) and 9 months of daily isoniazid (9H). Completion rate, ADE, and reasons for treatment termination were recorded. Factors associated with treatment termination and ADE were analyzed using multivariate logistic regression. In all, 91 treatment courses (41 9H and 50 3HP) were surveyed. The completion rates were 61% for 9H and 82% for 3HP (P = 0.046). Use of 9H and development of ADE with a grade of ≥2 (≥grade 2 ADE) were associated with treatment termination. Hypersensitivity occurred in 29.2% of subjects in the 3HP group and 10.8% in the 9H group (P = 0.035) and independently correlated with 3HP regimen, diabetes mellitus (DM), and peritoneal dialysis (PD). Similarly, the independent predictors of ≥grade 2 ADE were use of 3HP regimen, presence of DM, and use of PD, whereas ≥grade 3 ADE were associated with eosinophil counts of >700/mm3 after 2 weeks of LTBI treatment even after adjustment for age and gender. In conclusion, for patients on dialysis, 3HP showed a higher rate of completion but also a higher rate of ≥grade 2 ADE than 9H. In addition, DM and PD were risk factors for ≥grade 2 ADE. Eosinophilia after 2-week treatment might be an alert for severe ADE.
Subjects
dialysis; drug-related side effects and adverse reactions; interferon gamma release tests; latent tuberculosis
SDGs
Other Subjects
amlodipine plus valsartan; bisoprolol; isoniazid; rifapentine; isoniazid; tuberculostatic agent; adult; adverse drug reaction; age; aged; aspiration pneumonia; chill; clinical trial; cohort analysis; diabetes mellitus; dizziness; drug hypersensitivity; drug megadose; drug withdrawal; eosinophil count; female; fever; flu like syndrome; gastrointestinal symptom; gender; human; hypertension; interferon gamma release assay; latent tuberculosis; major clinical study; malaise; male; middle aged; multivariate logistic regression analysis; myalgia; peritoneal dialysis; priority journal; prospective study; Review; risk factor; treatment duration; young adult; adverse drug reaction; combination drug therapy; hemodialysis; Taiwan; Antitubercular Agents; Drug Therapy, Combination; Drug-Related Side Effects and Adverse Reactions; Humans; Isoniazid; Latent Tuberculosis; Prospective Studies; Renal Dialysis; Taiwan
Type
journal article