Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.21/14953 |
Resumo: | Background: We aimed to synthesize the evidence on the efficacy and safety of different treatment regimens for latent tuberculosis infection (LTBI) in children and adolescents. Methods: A systematic review with network meta-analysis was performed (CRD142933). Searches were conducted in Pubmed and Scopus (Nov-2021). Randomized controlled trials comparing treatments for LTBI (patients up to 15 years), and reporting data on the incidence of the disease, death, or adverse events were included. Networks using the Bayesian framework were built for each outcome of interest. Results were reported as odds ratio (OR) with 95% credibility intervals (CrI). Rank probabilities were calculated via the surface under the cumulative ranking analysis (SUCRA) (Addis-v.1.16.8). GRADE approach was used to rate evidence's certainty. Results: Seven trials (n = 8696 patients) were included. Placebo was significantly associated with a higher incidence of tuberculosis compared to all active therapies. Combinations of isoniazid (15–25 mg/kg/week) plus rifapentine (300–900 mg/week), followed by isoniazid plus rifampicin (10 mg/kg/day) were ranked as best approaches with lower probabilities of disease incidence (10% and 19.5%, respectively in SUCRA) and death (20%). Higher doses of isoniazid monotherapy were significantly associated with more deaths (OR 18.28, 95% ICr [1.02, 48.60] of 4–6 mg/kg/day vs. 10 mg/kg/3x per week). Conclusions: Combined therapies of isoniazid plus rifapentine or rifampicin for short-term periods should be used as the first-line approach for treating LTBI in children and adolescents. The use of long-term isoniazid as monotherapy and at higher doses should be avoided for this population. |
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Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescentsTuberculosisAntitubercular agentsInfantSystematic reviewNetwork meta-analysisBackground: We aimed to synthesize the evidence on the efficacy and safety of different treatment regimens for latent tuberculosis infection (LTBI) in children and adolescents. Methods: A systematic review with network meta-analysis was performed (CRD142933). Searches were conducted in Pubmed and Scopus (Nov-2021). Randomized controlled trials comparing treatments for LTBI (patients up to 15 years), and reporting data on the incidence of the disease, death, or adverse events were included. Networks using the Bayesian framework were built for each outcome of interest. Results were reported as odds ratio (OR) with 95% credibility intervals (CrI). Rank probabilities were calculated via the surface under the cumulative ranking analysis (SUCRA) (Addis-v.1.16.8). GRADE approach was used to rate evidence's certainty. Results: Seven trials (n = 8696 patients) were included. Placebo was significantly associated with a higher incidence of tuberculosis compared to all active therapies. Combinations of isoniazid (15–25 mg/kg/week) plus rifapentine (300–900 mg/week), followed by isoniazid plus rifampicin (10 mg/kg/day) were ranked as best approaches with lower probabilities of disease incidence (10% and 19.5%, respectively in SUCRA) and death (20%). Higher doses of isoniazid monotherapy were significantly associated with more deaths (OR 18.28, 95% ICr [1.02, 48.60] of 4–6 mg/kg/day vs. 10 mg/kg/3x per week). Conclusions: Combined therapies of isoniazid plus rifapentine or rifampicin for short-term periods should be used as the first-line approach for treating LTBI in children and adolescents. The use of long-term isoniazid as monotherapy and at higher doses should be avoided for this population.ElsevierRCIPLSantos, Josiane M.Fachi, Mariana M.Beraldi-Magalhães, FranciscoBöger, BeatrizJunker, Allan M.Domingos, Eric L.Imazu, PriscilaFernandez-Llimos, FernandoTonin, FernandaPontarolo, Roberto2022-122022-12-01T00:00:00Z2024-09-08T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.21/14953engSantos JM, Fachi MM, Beraldi-Magalhães F, Böger B, Junker AM, Tonin FS, et al. Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents. J Infect Chemother. 2022;28(12):1645-53.10.1016/j.jiac.2022.08.023info:eu-repo/semantics/embargoedAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-09-06T02:15:48Zoai:repositorio.ipl.pt:10400.21/14953Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:22:42.624531Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents |
title |
Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents |
spellingShingle |
Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents Santos, Josiane M. Tuberculosis Antitubercular agents Infant Systematic review Network meta-analysis |
title_short |
Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents |
title_full |
Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents |
title_fullStr |
Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents |
title_full_unstemmed |
Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents |
title_sort |
Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents |
author |
Santos, Josiane M. |
author_facet |
Santos, Josiane M. Fachi, Mariana M. Beraldi-Magalhães, Francisco Böger, Beatriz Junker, Allan M. Domingos, Eric L. Imazu, Priscila Fernandez-Llimos, Fernando Tonin, Fernanda Pontarolo, Roberto |
author_role |
author |
author2 |
Fachi, Mariana M. Beraldi-Magalhães, Francisco Böger, Beatriz Junker, Allan M. Domingos, Eric L. Imazu, Priscila Fernandez-Llimos, Fernando Tonin, Fernanda Pontarolo, Roberto |
author2_role |
author author author author author author author author author |
dc.contributor.none.fl_str_mv |
RCIPL |
dc.contributor.author.fl_str_mv |
Santos, Josiane M. Fachi, Mariana M. Beraldi-Magalhães, Francisco Böger, Beatriz Junker, Allan M. Domingos, Eric L. Imazu, Priscila Fernandez-Llimos, Fernando Tonin, Fernanda Pontarolo, Roberto |
dc.subject.por.fl_str_mv |
Tuberculosis Antitubercular agents Infant Systematic review Network meta-analysis |
topic |
Tuberculosis Antitubercular agents Infant Systematic review Network meta-analysis |
description |
Background: We aimed to synthesize the evidence on the efficacy and safety of different treatment regimens for latent tuberculosis infection (LTBI) in children and adolescents. Methods: A systematic review with network meta-analysis was performed (CRD142933). Searches were conducted in Pubmed and Scopus (Nov-2021). Randomized controlled trials comparing treatments for LTBI (patients up to 15 years), and reporting data on the incidence of the disease, death, or adverse events were included. Networks using the Bayesian framework were built for each outcome of interest. Results were reported as odds ratio (OR) with 95% credibility intervals (CrI). Rank probabilities were calculated via the surface under the cumulative ranking analysis (SUCRA) (Addis-v.1.16.8). GRADE approach was used to rate evidence's certainty. Results: Seven trials (n = 8696 patients) were included. Placebo was significantly associated with a higher incidence of tuberculosis compared to all active therapies. Combinations of isoniazid (15–25 mg/kg/week) plus rifapentine (300–900 mg/week), followed by isoniazid plus rifampicin (10 mg/kg/day) were ranked as best approaches with lower probabilities of disease incidence (10% and 19.5%, respectively in SUCRA) and death (20%). Higher doses of isoniazid monotherapy were significantly associated with more deaths (OR 18.28, 95% ICr [1.02, 48.60] of 4–6 mg/kg/day vs. 10 mg/kg/3x per week). Conclusions: Combined therapies of isoniazid plus rifapentine or rifampicin for short-term periods should be used as the first-line approach for treating LTBI in children and adolescents. The use of long-term isoniazid as monotherapy and at higher doses should be avoided for this population. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-12 2022-12-01T00:00:00Z 2024-09-08T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.21/14953 |
url |
http://hdl.handle.net/10400.21/14953 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Santos JM, Fachi MM, Beraldi-Magalhães F, Böger B, Junker AM, Tonin FS, et al. Systematic review with network meta-analysis on the treatments for latent tuberculosis infection in children and adolescents. J Infect Chemother. 2022;28(12):1645-53. 10.1016/j.jiac.2022.08.023 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/embargoedAccess |
eu_rights_str_mv |
embargoedAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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