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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2017

Open Access 01-12-2017 | Research article

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

Authors: Christopher Pease, Brian Hutton, Fatemeh Yazdi, Dianna Wolfe, Candyce Hamel, Pauline Quach, Becky Skidmore, David Moher, Gonzalo G. Alvarez

Published in: BMC Infectious Diseases | Issue 1/2017

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Abstract

Background

We 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.

Methods

We 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.

Results

Sixteen 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.

Conclusions

Most 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.
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Metadata
Title
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
Authors
Christopher Pease
Brian Hutton
Fatemeh Yazdi
Dianna Wolfe
Candyce Hamel
Pauline Quach
Becky Skidmore
David Moher
Gonzalo G. Alvarez
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-017-2377-x

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