Adverse drug reaction prevalence and mechanisms of action of first-line anti-tubercular drugs

Imam, Faisal; Sharma, Manju; Khayyam, Khalid Umer; Al-Harbi, Naif O.; Rashid, Mohd. Khan; Ali, Mohammad Daud; Ahmad, Ayaz; Qamar, Wajhul

doi:10.1016/j.jsps.2020.01.011

Cited by 26 publications

(23 citation statements)

References 21 publications

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“…However, most of the patients who had hyperuricemia were asymptomatic, not requiring treatment, but part of them had arthralgia, sometimes requiring nonsteroidal anti-inflammatory drugs to treat symptoms. Another study also found arthralgia as an ADR during TB treatment (15), however, in this study, tests were requested just for patients who had specific complains and not in a routine basis like in our study; such difference might explain the lower detection of hyperuricemia observed by Iman et al (15).…”

Section: Discussioncontrasting

confidence: 56%

“…Other studies performed in Brazil have reported a wide range in incidence of ADR, between 23.6% (13) and 83.4% (14). In another study with 1011 participants, conducted in India, the authors found around 35% of ADR, but included different regimens in the analyses and laboratory tests were done just for patients who developed suggestive clinical signs and symptoms (15). In our analyses, we accounted for clinical and laboratory data (even for patients without symptoms), which may have contributed to the increased ADR detection.…”

Section: Discussionmentioning

confidence: 99%

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Adverse Drug Reactions Related to Treatment of Drug-Susceptible Tuberculosis in Brazil: A Prospective Cohort Study

et al. 2022

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Standard anti-tuberculosis treatment is highly effective, but a great challenge is the management of adverse drug reactions (ADR). Our study aimed to characterize ADR according to type, severity and time of occurrence. A prospective tuberculosis (TB) cohort has been followed, from 2010 to 2016, at a reference center in Rio de Janeiro, Brazil. Clinical and laboratory tests information were collected in all visits. ADR were described according to the affected organ/system, classified as clinical and/or laboratory, early (first 2 months) or late. ADR’s causality and intensity were assessed. In our study 552 patients were included, 78.8% presented at least one ADR, 34% were people living with HIV (PLHIV). Most ADR were clinical (53%), early (82.5%), mild/moderate (88.7%) events and of “metabolic annutritional disorders” category. There were no significant differences in type, severity or causality between “early” and “late” groups. However, “early” group presented a higher frequency of “metabolic and nutritional disorders” (27.8%) and “gastrointestinal system disorders” (23.5%), while “skin and appendages disorders” were more frequent in the “late” group. ADR are frequent and occur at any time during treatment, although the majority are early and grade and not severe.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Adverse Drug Reactions Related to Treatment of Drug-Susceptible Tuberculosis in Brazil: A Prospective Cohort Study

et al. 2022

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“…Despite the high success rate, HRZE contributes to several adverse events, including hepatotoxicity, hyperuricemia, peripheral neuritis, hypersensitivity, visual toxicity, cutaneous reactions, flu-like syndrome, ototoxicity, fever, gastrointestinal intolerance, and psychiatric changes. The prevalence of adverse effects is more significant in elderly patients as the susceptibility increases with age [ 26 , 27 , 28 ]. Table 2 outlines the details on the first-line drugs with their targets, mechanism of actions, and mutations that may occur in Mtb that render them ineffective.…”

Section: Current Antituberculosis Drugsmentioning

confidence: 99%

Antituberculosis Targeted Drug Delivery as a Potential Future Treatment Approach

et al. 2021

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Mycobacterium tuberculosis (Mtb) is the microorganism that causes tuberculosis. This infectious disease has been around for centuries, with the earliest record of Mtb around three million years ago. The discovery of the antituberculosis agents in the 20th century has managed to improve the recovery rate and reduce the death rate tremendously. However, the conventional antituberculosis therapy is complicated by the development of resistant strains and adverse drug reactions experienced by the patients. Research has been conducted continuously to discover new, safe, and effective antituberculosis drugs. In the last 50 years, only two molecules were approved despite laborious work and costly research. The repurposing of drugs is also being done with few drugs; antibiotics, particularly, were found to have antituberculosis activity. Besides the discovery work, enhancing the delivery of currently available antituberculosis drugs is also being researched. Targeted drug delivery may be a potentially useful approach to be developed into clinically accepted treatment modalities. Active targeting utilizes a specifically designed targeting agent to deliver a chemically conjugated drug(s) towards Mtb. Passive targeting is very widely explored, with the development of multiple types of nanoparticles from organic and inorganic materials. The nanoparticles will be engulfed by macrophages and this will eliminate the Mtb that is present in the macrophages, or the encapsulated drug may be released at the sites of infections that may be in the form of intra- and extrapulmonary tuberculosis. This article provided an overview on the history of tuberculosis and the currently available treatment options, followed by discussions on the discovery of new antituberculosis drugs and active and passive targeting approaches against Mycobacterium tuberculosis.

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“…Such ADRs pose a challenge in the management of TB. Though it is a prolonged treatment, medication must be continued in order to ensure the compliance, otherwise it will end with treatment failure or developing antimicrobial resistance [10]. Generally, patients discontinue the medication due to the emergence of ADRs resulting from the administration of first-line anti-TB drugs.…”

Section: Introductionmentioning

confidence: 99%

Adverse Drug Reactions Associated with Anti-Tuberculosis Therapy

Kalaiselvan¹,

Shukla²,

Kumar³

et al. 2021

New Insights Into the Future of Pharmacoepidemiology and Drug Safety

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The pharmacovigilance has been evolved as a professional and ethical practice in ensuring the safety of medicines. The Adverse Drug Reactions (ADRs) associated with the use of medicines including Anti-Tuberculous Therapy (ATT) through a robust system of pharmacovigilance helps in promoting the safety of patients at large. The occurrence of ADRs associated with the use of ATT is expected, a large number of medicines are combined and used for prolonged duration. The suspected ADRs associated with first line ATT are well documented. However, the drugs used in second line or multidrug resistant to tuberculosis (TB), namely bedaquiline, reported to cause QT prolongation in electrocardiogram reading as one of the most common ADRs. Therefore, early identification and prevention of ADRs during ATT is essential for promoting the rational use and reduce the burden of anti-microbial resistance, besides achieving better treatment outcomes.

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Adverse drug reaction prevalence and mechanisms of action of first-line anti-tubercular drugs

Cited by 26 publications

References 21 publications

Adverse Drug Reactions Related to Treatment of Drug-Susceptible Tuberculosis in Brazil: A Prospective Cohort Study

Adverse Drug Reactions Related to Treatment of Drug-Susceptible Tuberculosis in Brazil: A Prospective Cohort Study

Antituberculosis Targeted Drug Delivery as a Potential Future Treatment Approach

Adverse Drug Reactions Associated with Anti-Tuberculosis Therapy

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