PDF(Pubmed)
Abstract：
Objectives: Accumulating evidence are available on the efficacy of high-dose isoniazid (INH) for multidrug-resistant tuberculosis (MDR-TB) treatment. We aimed to perform a systematic review and meta-analysis to compare clinical efficacy and safety outcomes of high-dose INH- containing therapy against other regimes. Methods: We searched the following databases PubMed, Embase, Scopus, Web of Science, CINAHL, the Cochrane Library, and ClinicalTrials.gov. We considered and included any studies comparing treatment success, treatment unsuccess, or adverse events in patients with MDR-TB treated with high-dose INH (>300 mg/day or >5 mg/kg/day). Results: Of a total of 3,749 citations screened, 19 studies were included, accounting for 5,103 subjects, the risk of bias was low in all studies. The pooled treatment success, death, and adverse events of high-dose INH-containing therapy was 76.5% (95% CI: 70.9%-81.8%; I2: 92.03%), 7.1% (95% CI: 5.3%-9.1%; I2: 73.75%), and 61.1% (95% CI: 43.0%-77.8%; I2: 98.23%), respectively. The high-dose INH administration is associated with significantly higher treatment success (RR: 1.13, 95% CI: 1.04-1.22; p < 0.01) and a lower risk of death (RR: 0.45, 95% CI: 0.32-0.63; p < 0.01). However, in terms of other outcomes (such as adverse events, and culture conversion rate), no difference was observed between high-dose INH and other treatment options (all p > 0.05). In addition, no publication bias was observed. Conclusion: In MDR-TB patients, high-dose INH administration is associated with a favorable outcome and acceptable adverse-event profile. Systematic review registration: identifier CRD42023438080.
摘要：
目标：关于高剂量异烟肼（INH）用于耐多药结核病（MDR-TB）治疗的有效性的证据越来越多。我们旨在进行系统评价和荟萃分析，以比较高剂量含INH治疗与其他方案的临床疗效和安全性结果。方法：我们搜索了以下数据库PubMed，Embase,Scopus,WebofScience,CINAHL,Cochrane图书馆,和ClinicalTrials.gov.我们考虑并纳入了任何比较治疗成功的研究，治疗不成功,或使用高剂量INH（>300mg/天或>5mg/kg/天）治疗的MDR-TB患者的不良事件。结果：在总共筛选的3,749篇引文中，包括19项研究，占5103个科目，所有研究的偏倚风险均较低.合并治疗成功，死亡,高剂量异烟肼治疗的不良事件为76.5%（95%CI：70.9%-81.8%；I2：92.03%），7.1%（95%CI：5.3%-9.1%；I2：73.75%），和61.1%（95%CI：43.0%-77.8%；I2：98.23%），分别。高剂量异烟肼给药与显著更高的治疗成功率(RR:1.13,95%CI:1.04-1.22;p<0.01)和更低的死亡风险(RR:0.45,95%CI:0.32-0.63;p<0.01)相关。然而,在其他结果方面(如不良事件，和文化转化率)，大剂量异烟肼与其他治疗方案无差异(均p>0.05).此外,未观察到发表偏倚.结论：在耐多药结核病患者中，大剂量异烟肼给药与良好的结局和可接受的不良事件有关.系统审查注册：标识符CRD42023438080。
