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Safety, Efficacy, and Pharmacokinetics of Daily Optimized Doses of Rifampicin for the Treatment of Tuberculosis: A Systematic Review and Bayesian Network Meta-Analysis

2025-01-10Artigo científico Acesso aberto
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dc.contributor.authorEspinosa-Pereiro, Juan
dc.contributor.authorAguiar, Ana
dc.contributor.authorNara, Eva
dc.contributor.authorMedina, Angelica
dc.contributor.authorMolinas, Gladys
dc.contributor.authorTavares, Margarida
dc.contributor.authorTortola, Teresa
dc.contributor.authorGhimire, Samiksha
dc.contributor.authorAlfenaar, Jan-Willem C.
dc.contributor.authorSturkenboom, Marieke G.G.
dc.contributor.authorMagis-Escurra, Cecile
dc.contributor.authorSánchez-Montalva, Adrián
dc.contributor.authorBarros, Henrique
dc.contributor.authorDuarte, Raquel
dc.date.accessioned2026-02-16T13:07:34Z
dc.date.available2026-02-16T13:07:34Z
dc.date.issued2025-01-10
dc.description.abstractBackground: Higher than standard doses of rifampicin could improve the treatment outcome of drug-susceptible tuberculosis (TB) without compromising the safety of patients. Methods: We performed a systematic review of prospective clinical studies including adults with pulmonary and extrapulmonary TB receiving rifampicin doses above 10 mg/kg/day. We extracted the data on overall adverse events (AE), hepatic AE, sputum culture conversion (SCC) at week 8, recurrence, mortality, and pharmacokinetics. We performed a Bayesian network meta-analysis (NMA) using a random-effects model. Results: In 19 studies, 2033 out of 3654 participants received rifampicin doses higher than 10 mg/kg/day. The NMA showed an increased risk of overall and hepatic AE for the 40 mg/kg/day dose (risk ratio [RR] 4.8, 95% credibility interval [CrI]: 1.1, 25, and 15.00; 95% CrI: 1.1, 58.0, respectively), but no other doses, including 50 mg/kg/day showed such an increase. Increasing doses improved sputum culture conversion at week 8 (RR 1.3, 95% CrI: 1.1, 1.7 for SCC with 35 mg/kg/day). Conclusions: Optimal doses of rifampicin may be between 25 and 35 mg/kg/day, but should be tailored at the individual or, at least, at the population level.eng
dc.description.sponsorshipThis work was supported by the Euroepan Research Council (ERC) under the European Union’s Horizon 2020 MSCA-RISE project European-Latin American TB Research Collaborative Network (EUSAT-RCS), grant agreement No. 823890. A. A. was supported by Fundação para a Ciência e a Tecnologia (FCT), I. P. through the projects with references UIDB/04750/2020 and LA/P/0064/2020 and DOI identifiers https://doi.org/10. 54499/UIDB/04750/2020 and https://doi.org/10.54499/LA/P/0064/2020. A. A. holds a PhD grant (Reference 2020.09390.BD DOI https://doi.org/ 10.54499/2020.09390.BD), cofunded by the Fundação para a Ciência e a Tecnologia (FCT) and the European Social Fund plus (ESF+)) Program.. J. E-P. holds a predoctoral Rio Hortega grant (reference CM22/00246), funded by the Instituto de Salud Carlos III.
dc.identifier.citationClin Infect Dis. 2025 Aug 1;81(1):129-142. doi: 10.1093/cid/ciaf003
dc.identifier.doi10.1093/cid/ciaf003
dc.identifier.eissn1537-6591
dc.identifier.issn1058-4838
dc.identifier.pmid39792625
dc.identifier.urihttp://hdl.handle.net/10400.18/10944
dc.language.isoeng
dc.peerreviewedyes
dc.publisherOxford University Press
dc.relationEuropean-Latin American TB Research Collaboration Network
dc.relationEpidemiology Research Unit - Institute of Public Health, University of Porto
dc.relationPsychological impact and social determinants in the Portuguese population during and after the COVID-19 pandemic
dc.relation.hasversionhttps://www.sciencedirect.com/science/article/pii/S0165572825001286?via%3Dihub
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectTuberculosis
dc.subjectRifampicin
dc.subjectClinical Trials
dc.subjectNetwork Meta-Analysis
dc.subjectSystematic Review
dc.subjectInfecções Respiratórias
dc.titleSafety, Efficacy, and Pharmacokinetics of Daily Optimized Doses of Rifampicin for the Treatment of Tuberculosis: A Systematic Review and Bayesian Network Meta-Analysiseng
dc.typejournal article
dcterms.referenceshttps://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/cid/81/1/10.1093_cid_ciaf003/1/ciaf003_supplementary_data.docx?Expires=1773867805&Signature=XClia-dWkmt2-CFXHPsRMsVM8-NebhMwIlcLfjwk7hLwZn4b34BDlozlT5qBFgt617sM0n-iK1EZGkC-xnLRFppMgI86xDoeo~2v6DV7DOorKOhkKdDOJU0bxyr59WnBxwwDjYt-1Uw4PR4RqxkfwjcLzRU4F0x8Q8NbERFCQpzsU1yLk6ks45kW2bJZakDFxYRNcyaHWiVCClLJL35SZkDQENsZeBAttVf-aqwdSDvk7IY9baXiwqfm~uEOHPX1~u4pvamXq-SGd5EU81KZ4c3DpqH4zQh2PL1VsqTN9XG1qFqIobW3hHvZJN2lMo1mQVbtNpNiueqquAUqNDTenw__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA
dcterms.referenceshttps://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/cid/81/1/10.1093_cid_ciaf003/1/ciaf003_supplementary_data.docx?Expires=1773867805&Signature=XClia-dWkmt2-CFXHPsRMsVM8-NebhMwIlcLfjwk7hLwZn4b34BDlozlT5qBFgt617sM0n-iK1EZGkC-xnLRFppMgI86xDoeo~2v6DV7DOorKOhkKdDOJU0bxyr59WnBxwwDjYt-1Uw4PR4RqxkfwjcLzRU4F0x8Q8NbERFCQpzsU1yLk6ks45kW2bJZakDFxYRNcyaHWiVCClLJL35SZkDQENsZeBAttVf-aqwdSDvk7IY9baXiwqfm~uEOHPX1~u4pvamXq-SGd5EU81KZ4c3DpqH4zQh2PL1VsqTN9XG1qFqIobW3hHvZJN2lMo1mQVbtNpNiueqquAUqNDTenw__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA
dspace.entity.typePublication
oaire.awardTitleEuropean-Latin American TB Research Collaboration Network
oaire.awardTitleEpidemiology Research Unit - Institute of Public Health, University of Porto
oaire.awardTitlePsychological impact and social determinants in the Portuguese population during and after the COVID-19 pandemic
oaire.awardURIhttp://hdl.handle.net/10400.18/10943
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB%2F04750%2F2020/PT
oaire.awardURIhttp://hdl.handle.net/10400.18/10495
oaire.citation.endPage142
oaire.citation.issue1
oaire.citation.startPage129
oaire.citation.titleClinical Infectious Diseases
oaire.citation.volume81
oaire.fundingStreamRISE
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStreamOE
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
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relation.isProjectOfPublication05f4f337-eeba-4c07-82ed-4202b21618a2
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