Adverse drug reactions &amp; drug interactions in MDR-TB patients

Gupta, Amitesh; Kumar, Vikas; Natarajan, Sekar; Singla, Rupak

doi:10.1016/j.ijtb.2020.09.027

Cited by 14 publications

(24 citation statements)

References 24 publications

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“…The psychiatric disorder prevalence was found to be in a range of 4% to 36% in individual studies among DR-TB patients ( Furin et al, 2001 ; Hoa et al, 2015 ). Anti-TB drugs suspected of psychiatric complications include isoniazid, fluoroquinolones, ethionamide, and cycloserine ( Carroll et al, 2012 ; WHO, 2014b ; Gupta et al, 2020 ). Apart from ADRs, societal stigma attached to the disease, the length of therapy, financial problems, and any previous therapy experiences also severely affect patients ( Tandon et al, 1980 ; Barnhoorn and Adriaanse, 1992 ; Kiecolt-Glaser and Glaser, 2002 ; Rajeswari et al, 2005 ; Furin et al, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

Frequency and Management of Adverse Drug Reactions Among Drug-Resistant Tuberculosis Patients: Analysis From a Prospective Study

et al. 2022

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Drug-resistant tuberculosis (DR-TB) management is often linked with a higher rate of adverse drug reactions (ADRs) needing effective and timely management of these ADRs, which, if left untreated, may result in a higher rate of loss to follow-up of drug-resistant patients.Study objective: The study was aimed at prospectively identifying the nature, frequency, suspected drugs, and management approaches for ADRs along with risk factors of ADRs occurrence among DR-TB patients at Nishtar Medical University, Hospital, Multan, Pakistan.Materials and Methods: The prospective study included all the DR-TB patients enrolled for treatment from January 2016 to May 2017 at the study site. Patients were evaluated for the treatment-induced ADRs as per standard criteria of the National Tuberculosis Program, Pakistan. Multivariate logistic regression was used to assess the independent variables associated with the occurrence of ADRs.Results: Out of 271 DR-TB patients included in the final analysis, it was observed that 55 patients (20.3%) experienced at least three ADRs. A total of 50 (18.5%) patients experienced zero adverse effects, while 15 (5.5%), 33 (12.2%), and 53 (19.6%) patients experienced one, two, and four ADRs, respectively. Gastrointestinal disturbances (66.7%), nervous system disorders (59.4%), and electrolyte disturbances (55.7%) remained the highest reported ADRs during therapy, followed by arthralgia (49.1%), ototoxicity (24%), pruritic reactions/rash (12.9%), dyspnoea (12.5%), and tinnitus (8.8%). Pulmonary cavitation at the baseline visit (p-value 0.001, OR 3.419; 95% CI (1.694–6.902) was significantly associated with the occurrence of ADRs among DR-TB patients.Conclusion: The frequency of ADRs was high among the study cohort; however, these were managed effectively. Patients with recognized risk factors for ADRs occurrence need continuous clinical management efforts.

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Section: Discussionmentioning

confidence: 99%

Frequency and Management of Adverse Drug Reactions Among Drug-Resistant Tuberculosis Patients: Analysis From a Prospective Study

et al. 2022

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“…Rifamycins (RIF, rifapentine [RPT], rifabutin) induce several cytochrome P450 (CYP450) enzymes and drug transporters, which can significantly decrease concentrations of drugs eliminated via these routes. 40 , 41 Conversely, INH inhibits a range of CYP450 enzymes, including CYP3A4 and therefore can increase concentrations of drugs metabolised by this enzyme. 42 As the inductive effect of RIF generally outweighs the inhibitory effect of INH, the overall effect is a net decrease in the concentrations of many drugs.…”

Section: Standardmentioning

confidence: 99%

Clinical standards for the dosing and management of TB drugs

Alffenaar

Stocker

Forsman

et al. 2022

int j tuberc lung dis

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BACKGROUND: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on ‘best practice´ for dosing and management of TB drugs.METHODS: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants.RESULTS: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified.CONCLUSION: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.

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“…treatment in the world remains low, since a significant share of patients interrupt treatment due to long-term (up to two years) therapy and the incidence of adverse drug events (AE) [4]. Development of AE can lead to a temporary interruption or discontinuation of MDR-TB chemotherapy [5][6][7].…”

Section: цель исследованияmentioning

confidence: 99%

“…Эффективность лечения МЛУ ТБ в мире остаётся низкой, так как значительная доля пациентов прерывает лечение вследствие длительной по времени (до двух лет) терапии и возникновением нежелательных явлений (НЯ) от лекарственных препаратов [4]. Возникновение НЯ может привести к временному прерыванию или прекращению химиотерапии МЛУ ТБ [5][6][7].…”

Section: Introductionunclassified