Risk Management Assessments of Anti-tuberculosis Adverse Drug Reaction: A Systematic Review

Abstract

To improve adherence to treatment, quality of life of patients on anti-tuberculosis drugs, and prevent antibiotic resistance, we conducted this systematic review to support risk minimization actions. Methods: Medline, Scopus, and Web of Science were searched with a focus on adverse drug reactions. Two independent reviewers assessed the methodological quality of the included studies using criteria defined by the Newcastle Ottawa Scale. Results: Seven studies were included, and four risk management strategies were identified (psychological intervention, drug dose reduction with or without prescription of adjunctive drugs, drug switching, permanent or temporary drug discontinuation). The strategies adopted were dependent on the nature and severity of the adverse events. All drugs responsible for serious adverse effects were changed or discontinued. Conclusions: The results highlight the relatively low frequency of adverse events leading to permanent discontinuation of 1st-line anti-tuberculosis drugs, but also emphasize the high incidence of adverse events leading to permanent discontinuation of cycloserine.