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CDC: Consider shortened combination treatment for TB prevention
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A shortened 3-month combination treatment for latent tuberculosis works as well as 9 months of therapy with isoniazid and can be used as an alternative in otherwise healthy patients who are at risk for developing tuberculosis, according to a report from the CDC.
The recommendations follow the publication of an earlier study by Timothy Sterling, MD, of Vanderbilt University Medical Center, and colleagues that looked at about 8,000 participants in four countries between 2001 and 2008.
Sterling and colleagues said 12 doses, given once weekly, of isoniazid combined with rifapentine (Priftin, Sanofi-Aventis) was as effective as the longer isoniazid regimen.
Seven of 3,986 participants in the combination group and 15 of 3,745 participants in the isoniazid-only group developed TB. The researchers said 82% of those in the combination group and 69% in the single-therapy group completed their regimen, which is key to preventing infectious spread.
Sterling and colleagues said continued research into the shortened treatment is necessary, adding that the new treatment is not an option for all patients and may not work well in nations where TB incidence is higher.
According to the CDC report, those who have a “predictive factor for greater likelihood of TB developing, which includes recent exposure to contagious TB, conversion from negative to position on an indirect test for infection and radiographic findings of healed pulmonary TB,” are recommended for the shortened combination regimen.
The CDC researchers also said patients with HIV who are otherwise healthy and not taking antiretroviral medications may consider this treatment. The preferred regimen for children aged 2 to 11 years remains the 9 months of therapy because “the number of children in this age range who have received (the combined therapy) is insufficient for assessing tolerability and efficacy.”
They said treatment regimens for latent TB remain unchanged.
For more information:
- CDC. MMWR. 2011;60:1650-1653.
- Sterling TR. N Engl J Med. 2011;365:2155-2166.
Disclosure: Dr. Sterling reported financial ties with Bristol-Myers Squibb and Pfizer for HIV observational studies. Other researchers reported receiving grant funding from Sanofi-Aventis and Otsuka America.
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