Risk Management Assessments of Anti-tuberculosis Adverse Drug Reaction: A Systematic Review

Boubacar Traore,Gladys Tsoumbou Bakana,Samira Nani,Samira Hassoune,S Bourekkadi,A Mokhtari,H Hami,K Slimani,A Soulaymani

doi:10.1051/e3sconf/202131901042

Boubacar Traore, Gladys Tsoumbou Bakana + Show 7 more

Open Access

https://doi.org/10.1051/e3sconf/202131901042

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Abstract

To improve adherence to treatment, quality of life of patients on anti-tuberculosis drugs, and prevent antibiotic resistance, we conducted this systematic review to support risk minimization actions. Methods: Medline, Scopus, and Web of Science were searched with a focus on adverse drug reactions. Two independent reviewers assessed the methodological quality of the included studies using criteria defined by the Newcastle Ottawa Scale. Results: Seven studies were included, and four risk management strategies were identified (psychological intervention, drug dose reduction with or without prescription of adjunctive drugs, drug switching, permanent or temporary drug discontinuation). The strategies adopted were dependent on the nature and severity of the adverse events. All drugs responsible for serious adverse effects were changed or discontinued. Conclusions: The results highlight the relatively low frequency of adverse events leading to permanent discontinuation of 1st-line anti-tuberculosis drugs, but also emphasize the high incidence of adverse events leading to permanent discontinuation of cycloserine.

Highlights

Antibiotic resistance, and TB drug resistance, has become a global threat with potential consequences for human health, animal health, and the environment
If dose reduction is an attitude adopted by clinicians to manage adverse effects, patients adopt poor compliance to manage adverse effects [3]
A total of 32 potentially relevant articles on the risk management of adverse drug reactions to anti-tuberculosis drugs were identified after an initial screening based on the titles and abstracts of candidate articles

Summary

Introduction

Antibiotic resistance, and TB drug resistance, has become a global threat with potential consequences for human health, animal health, and the environment. 206,030 cases of multidrugresistant tuberculosis (a 10% increase from 2018) have been identified among the 10 million cases of tuberculosis detected and reported in 2019. 1.4 million TB deaths were reported in 2019 [1]. Antibiotic resistance results from poor adherence to treatment, insufficient dosage, pharmacokinetic interaction or insufficient antibacterial activity leading to inappropriate use and selection of resistant mutants [2]. If dose reduction (insufficient dosage) is an attitude adopted by clinicians to manage adverse effects, patients adopt poor compliance to manage adverse effects [3]. The treatment of tuberculosis and multidrugresistant tuberculosis requires long-term therapy with a combination of several drugs. Adverse effects are much more common with these drugs, especially those used for the treatment of MDR-TB

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Conclusion