Efficacy and safety of a four-drug fixed-dose combination regimen versus separate drugs for treatment of pulmonary tuberculosis: a systematic review and meta-analysis
Braz. j. microbiol
; 48(2): 198-207, April.-June 2017. tab, graf
Article
in English
| LILACS
| ID: biblio-839364
Responsible library:
BR1.1
ABSTRACT
Abstract Introduction:
Tuberculosis, particularly multi-drug-resistant tuberculosis, is a major cause of morbidity and mortality worldwide. To the best of our knowledge, however, no study to date has assessed the combined use of the four available drugs for tuberculosis treatment, which is an issue of great clinical relevance.Objective:
To determine whether the four-drug fixed-dose combination is safer or more effective than separate drugs for treatment of pulmonary tuberculosis.Methods:
A systematic review of the literature was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results:
In pooled results from five randomized controlled trials with 3502 patients across Africa, Asia, and Latin America, four-drug fixed-dose combination therapy was no better than separate drugs therapy in terms of culture conversion after 2 and 6 months of treatment. There were no significant differences between the groups in overall incidence of adverse effects. However, the meta-analytic measure (log odds ratio) revealed that separate drugs treatment had a 1.65 [exp (0.5) = 1.65] increased chance of gastrointestinal adverse effects compared to four-drug fixed-dose combination treatment.Conclusions:
The reviewed studies showed that four-drug fixed-dose combination therapy provides greater patient comfort by reducing the number of pills and the incidence of gastrointestinal adverse effects, as well as simplifying pharmaceutical management at all levels.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Health and Well-Being
/
Neglected Diseases
/
SDG3 - Target 3.3 End transmission of communicable diseases
/
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Target 3.3: End transmission of communicable diseases
/
Neglected Diseases
/
Tuberculosis
/
Tuberculosis
/
Other Respiratory Diseases
Database:
LILACS
Main subject:
Tuberculosis, Pulmonary
/
Antitubercular Agents
Type of study:
Controlled clinical trial
/
Practice guideline
/
Systematic review
Limits:
Humans
Country/Region as subject:
Africa
Language:
English
Journal:
Braz. j. microbiol
Journal subject:
Microbiology
Year:
2017
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Laboratório Central de Saúde Pública/BR