Isoniazid Chemoprophylaxis of Latent Primary Tuberculosis: in Five Trial Centres in France from 1959 to 1969

Debré, R; Perdrizet, S; Lötte, A; Naveau, Mikaël; Lert, France

doi:10.1093/ije/2.2.153

Cited by 30 publications

(16 citation statements)

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“…Totals of 16 studies ( n = 44,149) [5, 20, 21, 23, 26, 29, 31, 32, 37, 41–44, 46, 48, 49] and 14 studies ( n = 44,128) [5, 20, 26, 27, 29, 31–33, 37, 41–44, 46] studies were included in the efficacy and completion NMAs, respectively. Thirteen studies met eligibility criteria but were judged to be heterogeneous related to aspects of endpoint definition, overlap of patients enrolled, treatment comparisons (which did not align with the network structure), and differences in patient population [6, 23–25, 30, 34, 36, 39, 45, 47, 50–52]; a section of the review’s supplemental information (see Additional file 1) details these studies and their findings.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses

et al. 2017

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BackgroundWe conducted a systematic review and network meta-analysis (NMA) to examine the efficacy and completion rates of treatments for latent tuberculosis infection (LTBI). While a previous review found newer, short-duration regimens to be effective, several included studies did not confirm LTBI, and analyses did not account for variable follow-up or assess completion.MethodsWe searched MEDLINE, Embase, CENTRAL, PubMed, and additional sources to identify RCTs in patients with confirmed LTBI that involved a regimen of interest and reported on efficacy or completion. Regimens of interest included isoniazid (INH) with rifapentine once weekly for 12 weeks (INH/RPT-3), 6 and 9 months of daily INH (INH-6; INH-9), 3–4 months daily INH plus rifampicin (INH/RFMP 3–4), and 4 months daily rifampicin alone (RFMP-4). NMAs were performed to compare regimens for both endpoints.ResultsSixteen RCTs (n = 44,149) and 14 RCTs (n = 44,128) were included in analyses of efficacy and completion. Studies were published between 1968 and 2015, and there was diversity in patient age and comorbidities. All regimens of interest except INH-9 showed significant benefits in preventing active TB compared to placebo. Comparisons between active regimens did not reveal significant differences. While definitions of regimen completion varied across studies, regimens of 3–4 months were associated with a greater likelihood of adequate completion.ConclusionsMost of the active regimens showed an ability to reduce the risk of active TB relative to no treatment, however important differences between active regimens were not found. Shorter rifamycin-based regimens may offer comparable benefits to longer INH regimens. Regimens of 3–4 months duration are more likely to be completed than longer regimens.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2377-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses

et al. 2017

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“…Among the eight studies, two included participants ( n = 810) who were HIV-infected [18,19]; one included HIV negative participants born to HIV-infected mothers ( n = 806) [19], and the other five included only HIV negative participants ( n = 8,703) irrespective of their exposure status [20-24]. Three of the eight studies included participants who were tuberculin skin test (TST) positive only [21,22,24], and two studies excluded participants who had BCG scars [22,24]. Three of the trials were conducted in southern Africa, one in India, one in France, one in Kenya, one in the US, and one at multiple sites in Mexico, the US and Canada.…”

Section: Resultsmentioning

confidence: 99%

“…Three of the trials were conducted in southern Africa, one in India, one in France, one in Kenya, one in the US, and one at multiple sites in Mexico, the US and Canada. The quality of six of the trials [18-21,23] was rated as high; the remaining two trials were rated as low quality [22,24]. …”

Section: Resultsmentioning

confidence: 99%

“…The study by Debre et al was not conducted in a blinded fashion, while the study by Gupta et al did not give details of how the randomized controlled trial was conducted; the authors acknowledged irregularities and defaults in drug intake in the latter study which may have influenced their results [22,24]. Concerning all of the studies, generally, diagnosis of TB is very difficult in children [34], particularly in infants and this may have led to failure to make a diagnosis, misdiagnosis or over diagnosis of the outcome, leading to a biased estimate of the efficacy of INH preventive therapy.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of isoniazid prophylactic therapy in prevention of tuberculosis in children: a meta–analysis

et al. 2014

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BackgroundChildren are highly susceptible to tuberculosis; thus, there is need for safe and effective preventive interventions. Our objective was to evaluate the efficacy of isoniazid in prevention of tuberculosis morbidity and mortality in children aged 15 years or younger by performing a meta-analysis of randomized controlled trials. To our knowledge, this is the first meta-analysis evaluating efficacy of isoniazid prophylaxis in prevention of tuberculosis in children.MethodsA systematic search of the literature was done to identify randomized controlled trials evaluating isoniazid prophylaxis efficacy among children. Each study was evaluated for relevance and validity for inclusion in the analysis. Subgroup analyses were conducted based on study quality, HIV status, tuberculosis endemicity, type of prophylaxis and age of participants.ResultsEight studies comprising 10,320 participants were included in this analysis. Upon combining data from all eight studies, isoniazid prophylaxis was found to be efficacious in preventing development of tuberculosis, with a pooled RR of 0.65 (95% CI 0.47, 0.89) p = 0.004 , with confidence intervals adjusted for heterogeneity. Among the sub-group analyses conducted, only age of the participants yielded dramatic differences in the summary estimate of efficacy, suggesting that age might be an effect modifier of the efficacy of isoniazid among children, with no effect realised in children initiating isoniazid at four months of age or earlier and an effect being present in older children. Excluding studies in which isoniazid was initiated at four months of age or earlier yielded an even stronger effect (RR = 0.41 (95% CI 0.31, 0.55) p <0.001). Data on the effect of isoniazid on all-cause mortality, excluding studies in which isoniazid was initiated in infants, yielded an imprecise estimate of mortality benefit (RR = 0.58 (95% CI 0.31, 1.09) p = 0.092).ConclusionIsoniazid prophylaxis reduces the risk of developing tuberculosis by 59% among children aged 15 years or younger excluding children initiated during early infancy for primary prophylaxis (RR = 0.41, 95% CI 0.31, 0.55 p < 0.001) . However, further studies are needed to assess effects on mortality and to determine prophylaxis effectiveness in very young children and among HIV-infected children.

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“…Of the 11 studies from the pre-HIV era, 4 ( 23 – 26 ) were excluded because resistance data from the control group were incomplete or not reported. In 2 studies ( 9 , 19 ), we excluded subgroups of persons with previously active disease, for which many had received isoniazid.…”

Section: Resultsmentioning

confidence: 99%

Isoniazid Preventive Therapy and Risk for Resistant Tuberculosis

Balcells

Thomas

Godfrey‐Faussett

et al. 2006

Emerg. Infect. Dis.

205

135

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Isoniazid Chemoprophylaxis of Latent Primary Tuberculosis: in Five Trial Centres in France from 1959 to 1969

Cited by 30 publications

References 0 publications

Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses

Efficacy and completion rates of rifapentine and isoniazid (3HP) compared to other treatment regimens for latent tuberculosis infection: a systematic review with network meta-analyses

Efficacy of isoniazid prophylactic therapy in prevention of tuberculosis in children: a meta–analysis

Isoniazid Preventive Therapy and Risk for Resistant Tuberculosis

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