• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

Randomized trial suggests that self-administered latent tuberculosis treatment is noninferior to direct observation

byEvelyn NguyenandDeepti Shroff Karhade
November 6, 2017
in Chronic Disease, Infectious Disease, Pulmonology
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Once-weekly isoniazid (INH) and rifapentine treatment for latent tuberculosis infection (LTBI) via self-administered therapy (SAT) had high completion rates in the United States (U.S.), Spain, and Hong Kong, and SAT was found to be noninferior to directly observed therapy (DOT) in the U.S.

2. Adverse events were similar in all groups and similar to previous reports.

Evidence Rating Level: 1 (Excellent)      

Study Rundown: LTBI transitioning to active infection constitutes approximately 86% of active TB cases in the U.S., which makes LTBI diagnosis and treatment important for preventing active cases.  Although once-weekly INH and rifapentine under DOT for 3 months is as effective as daily INH SAT for 9 months, DOT is often too costly for TB programs, not offered by primary care providers, and not accepted by patients.  This randomized clinical trial compared completion of treatment and safety of once-weekly INH and rifapentine via DOT to that via SAT.  Of treatment sites in four countries studied, researchers found that rates of SAT treatment completion were high in the U.S., Spain, and Hong Kong.  The study design did not allow the cause of low completion rates in South Africa to be determined.  In the U.S., SAT without reminders was noninferior to DOT.  Noninferiority criteria were not met by SAT-with-reminders groups in the U.S. or SAT groups with or without reminders in the other countries.  Adverse events were few and similar for all groups.  Study results suggest that once-weekly INH and rifapentine SAT could be a suitable treatment option for LTBI in the U.S. and in areas where DOT is unfeasible.

Strengths of the study include participants representative of LTBI patients receiving treatment at public health clinics and use of multiple U.S. treatment sites, which may assist in generalizability in the U.S.  A limitation is that more complicated packaging (compared to clinical use) used to organize medication doses and to track pill bottle openings may have been a factor in reduced treatment completion for the SAT groups.  Also, receipt of reminders was not confirmed for patients in the SAT-with-reminders group.

Click to read the study in Annals of Internal Medicine

Click to read an accompanying editorial in Annals of Internal Medicine 

RELATED REPORTS

#VisualAbstract: Non-severe tuberculosis in children can be treated with a shorter 4-month regimen instead of 6-month regimen

Non-severe tuberculosis in children can be treated with a shorter 4-month regimen

#VisualAbstract: Rifapentine-moxifloxacin noninferior to standard of care treatment for pulmonary tuberculosis

Relevant Reading: Tuberculosis treatment outcomes: directly observed therapy compared with self-administered therapy

In-Depth [randomized controlled trial]: This phase 4 randomized clinical trial included 1002 participants ≥18 years of age who were recommended for LTBI treatment.  Participants were a median age of 36 years, 48% women, and 77% enrolled at sites in the U.S.  The study was conducted at 9 U.S. sites and 1 site each in Spain, Hong Kong, and South Africa.  Participants received once-weekly INH and rifapentine via DOT, SAT with monitoring each month, or SAT with both monthly monitoring and weekly text message reminders.  The primary and secondary outcomes were completion of treatment (≥11 doses within 16 weeks) and adverse events, respectively.  The study design was a noninferiority trial with a maximum treatment completion decrease of 15%.  Overall, treatment completion for the DOT, SAT, and SAT-with-reminders groups were 87.2%, 74.0%, and 76.4%, respectively.  In the U.S., treatment completion for the DOT, SAT, and SAT-with-reminders groups were 85.4%, 77.9%, and 76.7%, respectively.  Adverse events (total, drug-related, and severe) were similar in all groups and similar to previous reports.

Image: PD

©2017 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: tuberculosis
Previous Post

More physicians are choosing shorter intravenous antibiotic courses for infantile urinary tract infections

Next Post

2 Minute Medicine Rewind November 6, 2017

RelatedReports

#VisualAbstract: COVID-19 vaccines provided durable protection from COVID-19, but their effectiveness waned over time in North Carolina
StudyGraphics

#VisualAbstract: Non-severe tuberculosis in children can be treated with a shorter 4-month regimen instead of 6-month regimen

April 13, 2022
Updated review confirms efficacy and safety of most standard treatments for latent tuberculosis infection
Chronic Disease

Non-severe tuberculosis in children can be treated with a shorter 4-month regimen

March 16, 2022
#VisualAbstract: Rifapentine-moxifloxacin noninferior to standard of care treatment for pulmonary tuberculosis
StudyGraphics

#VisualAbstract: Rifapentine-moxifloxacin noninferior to standard of care treatment for pulmonary tuberculosis

May 18, 2021
Updated review confirms efficacy and safety of most standard treatments for latent tuberculosis infection
Chronic Disease

Rifapentine-moxifloxacin noninferior to standard of care treatment for pulmonary tuberculosis

May 10, 2021
Next Post
Stroke expansion following intra-arterial therapy may explain worse outcomes

2 Minute Medicine Rewind November 6, 2017

Type 2 diabetes associated with reduction in disability-free life years

ACE-inhibitors and statins do not impact albuminuria in adolescents with type 1 diabetes mellitus: The AdDIT trial

Sleep duration inversely related to childhood type 2 diabetes risk makers

High intensity specialized intervention content following family-based intervention yields improved childhood weight loss

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Risk of post-vitrectomy endophthalmitis may have increased during the COVID-19 pandemic
  • Bosniak classification system differentiates benign renal cysts from cystic carcinoma [Classics Series]
  • Cognitive behavioral therapy efficacious for treatment of comorbid posttraumatic headache and posttraumatic stress disorder symptoms among US veterans
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.