Completion likely with self-administration of TB treatment

(HealthDay)—Most people complete treatment for latent tuberculosis (TB) without direct observation, according to a study published online Nov. 6 in the Annals of Internal Medicine.

Robert Belknap, M.D., from the University of Colorado Health Sciences Center in Denver, and colleagues compared treatment completion (11 or more doses within 16 weeks) and safety of once-weekly isoniazid and rifapentine by self-administration versus direct observation. A total of 1,002 adult patients with latent tuberculosis infection were recruited from outpatient tuberculosis clinics in the United States (77 percent), Spain, Hong Kong, and South Africa.

The researchers found that overall, treatment completion was 87.2 percent (95 percent confidence interval, 83.1 to 90.5 percent) in the direct observation group , 74 percent (95 percent confidence interval, 68.9 to 78.6 percent) in the self-administration group, and 76.4 percent (95 percent confidence interval, 71.3 to 80.8 percent) in the self-administration-with-reminders group. In the United States, treatment completion was 85.4 percent (95 percent confidence interval, 80.4 to 89.4 percent), 77.9 percent (95 percent confidence interval, 72.7 to 82.6 percent), and 76.7 percent (95 percent confidence interval, 70.9 to 81.7 percent), respectively, and self-administered therapy without reminders was noninferior to direct observation. No other comparisons met noninferiority criteria.

"This self-administered regimen with monthly monitoring may be an acceptable strategy for treating latent TB infection in the United States and could be considered in countries with similar approaches to TB prevention when directly observed therapy is not feasible," conclude the authors.

Several authors disclosed ties to pharmaceutical companies, including Sanofi, which donated study drugs.

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