Isoniazid-Rifapentine for Latent Tuberculosis Infection: A Systematic Review and Meta-analysis

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Njie, Gibril J. ; Morris, Sapna Bamrah ; Woodruff, Rachel Yelk ; Moro, Ruth N. ; Vernon, Andrew A. ; Borisov, Andrey S.
• Description:
  Context:
  
  Latent tuberculosis infection diagnosis and treatment is a strategic priority for eliminating tuberculosis in the U.S. The Centers for Disease Control and Prevention has recommended the short-course regimen of 3-month isoniazid-rifapentine administered by directly observed therapy. However, longer-duration regimens remain the most widely prescribed latent tuberculosis infection treatments. Limitation on adoption of 3-month isoniazid-rifapentine in the U.S. might be because of patients’ preference for self-administered therapy, providers’ lack of familiarity with 3-month isoniazid-rifapentine, or lack of resources to support directly observed therapy. This review examines the most recent evidence regarding 3-month isoniazid-rifapentine’s effectiveness, safety, and treatment completion when directly compared with other latent tuberculosis infection regimens primarily comprising 9-month isoniazid treatment.
  
  Evidence acquisition:
  
  Using Community Guide methodology, reviewers identified, evaluated, and summarized available evidence published during January 2006–June 2017. Analysis of the data was completed in 2017.
  
  Evidence synthesis:
  
  The analysis included 15 unique studies. Three-month isoniazid-rifapentine was determined to be equal to other latent tuberculosis infection regimens in effectiveness (OR 0.89, 95% CI=0.46, 1.70), and has higher treatment completion (87.5%, 95% CI=83.2%, 91.3%) compared with other latent tuberculosis infection regimens (65.9%, 95% CI=53.5%, 77.3%). Three-month isoniazid-rifapentine was associated with similar risk to other latent tuberculosis infection regimens for adverse events (relative risk=0.59, 95% CI=0.23, 1.52); discontinuing treatment because of adverse events (relative risk=0.48, 95% CI=0.17, 1.34); and death (relative risk=0.79, 95% CI=0.56, 1.11).
  
  Conclusions:
  
  The 3-month isoniazid-rifapentine regimen is as safe and effective as other recommended latent tuberculosis infection regimens and achieves significantly higher treatment completion rates.
  
  
• Subjects:
  Article
• Source:
  Am J Prev Med. 55(2):244-252
• Pubmed ID:
  29910114
• Pubmed Central ID:
  PMC6097523
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Volume:
  55
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:bcfcf2e395be6ca8434f0a88a7093b50412be53419493ee44c59035fef65846e
• Download URL:
  https://stacks.cdc.gov/view/cdc/58194/cdc_58194_DS1.pdf
• File Type:
  [PDF - 433.15 KB ]