Rifampin Similar to Isoniazid for Preventing Active Tuberculosis

Rifampin has significantly higher rate of treatment completion, fewer drug-related adverse events.
Rifampin has significantly higher rate of treatment completion, fewer drug-related adverse events.

HealthDay News — A 4-month regimen of rifampin is similar to a 9-month regimen of isoniazid for the prevention of active tuberculosis, according to a study published in the August 2 issue of the New England Journal of Medicine.

Dick Menzies, MD, from McGill University in Montreal, and colleagues conducted a multinational study in which they randomly assigned adults with latent tuberculosis infection to receive treatment with a 4-month regimen of rifampin (3443 patients) or a 9-month regimen of isoniazid (3416 patients) for the prevention of confirmed active tuberculosis within 28 months after randomization. 

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In the rifampin group, the researchers found that confirmed active tuberculosis developed in four patients and clinically diagnosed active tuberculosis developed in four patients, compared to 4 and 5 patients, respectively, in the isoniazid group, during 7652 person-years of follow-up. The rifampin regimen was not superior to the isoniazid regimen, as the upper boundaries of the 95% confidence interval for the rate differences of the confirmed cases and for the confirmed or clinically diagnosed cases of tuberculosis were less than the prespecified non-inferiority margin of 0.75 percentage points in cumulative incidence.

"The four-month regimen of rifampin was not inferior to the nine-month regimen of isoniazid for the prevention of active tuberculosis and was associated with a higher rate of treatment completion and better safety," the authors write.

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