Adverse drug reactions of first-line antitubercular drugs: A retrospective study on characteristics, management, factors, and impacts

Objective: To elucidate the characteristics, management strategies, risk factors, and clinical impacts associated with adverse drug reactions (ADRs) induced by first-line antitubercular drugs to enhance tuberculosis (TB) management. Methods: A retrospective cohort study was conducted by retrieving d...

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Main Authors: Ai Ling Oh, Mohd Makmor-Bakry, Farida Islahudin, Chuo Yew Ting, Swee Kim Chan, Siew Teck Tie
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-10-01
Series:Asian Pacific Journal of Tropical Medicine
Subjects:
Online Access:https://journals.lww.com/10.4103/apjtm.apjtm_72_24
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author Ai Ling Oh
Mohd Makmor-Bakry
Farida Islahudin
Chuo Yew Ting
Swee Kim Chan
Siew Teck Tie
author_facet Ai Ling Oh
Mohd Makmor-Bakry
Farida Islahudin
Chuo Yew Ting
Swee Kim Chan
Siew Teck Tie
author_sort Ai Ling Oh
collection DOAJ
description Objective: To elucidate the characteristics, management strategies, risk factors, and clinical impacts associated with adverse drug reactions (ADRs) induced by first-line antitubercular drugs to enhance tuberculosis (TB) management. Methods: A retrospective cohort study was conducted by retrieving drug-susceptible TB records among adult patients who received TB treatment from 2018 to 2021 at 10 public health clinics in Sarawak, Malaysia. Only the initial TB treatment and occurrence of specific ADRs within the study period were considered. Regression analysis was performed to identify the risk factors associated with both overall ADRs and individual types of ADRs. Results: Among 2 953 cases, 705 (23.9%) developed ADRs. Cutaneous reactions were the most prevalent (47.1%), followed by hepatotoxicity (32.8%) and gastrointestinal disturbances (29.8%). Six out of seven types of ADRs investigated occurred within the intensive phase, mostly manifesting at approximately 2 weeks of initiation. Hepatotoxicity resulted in the majority (85.3%) of treatment discontinuations, while vision problems led to treatment modifications in half of the cases. Risk factors for all ADRs included age ≥60 years, females, illicit drug use, and comorbidities such as HIV-positive, diabetes, and chronic liver disease. Alcohol consumption was independently associated with hepatotoxicity. ADRs caused around one-third of interruptions exceeding 2 weeks (33.0%) and subsequently necessitated treatment restarts (34.5%). Conclusions: Understanding these various aspects contributes to improving the overall management of ADRs in TB treatment. Close ADR monitoring and reporting are essential to strengthen ADR management.
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spelling doaj-art-a4ac376941024f8280019ea84fb8e4e12025-08-20T02:17:59ZengWolters Kluwer Medknow PublicationsAsian Pacific Journal of Tropical Medicine2352-41462024-10-01171045646410.4103/apjtm.apjtm_72_24Adverse drug reactions of first-line antitubercular drugs: A retrospective study on characteristics, management, factors, and impactsAi Ling OhMohd Makmor-BakryFarida IslahudinChuo Yew TingSwee Kim ChanSiew Teck TieObjective: To elucidate the characteristics, management strategies, risk factors, and clinical impacts associated with adverse drug reactions (ADRs) induced by first-line antitubercular drugs to enhance tuberculosis (TB) management. Methods: A retrospective cohort study was conducted by retrieving drug-susceptible TB records among adult patients who received TB treatment from 2018 to 2021 at 10 public health clinics in Sarawak, Malaysia. Only the initial TB treatment and occurrence of specific ADRs within the study period were considered. Regression analysis was performed to identify the risk factors associated with both overall ADRs and individual types of ADRs. Results: Among 2 953 cases, 705 (23.9%) developed ADRs. Cutaneous reactions were the most prevalent (47.1%), followed by hepatotoxicity (32.8%) and gastrointestinal disturbances (29.8%). Six out of seven types of ADRs investigated occurred within the intensive phase, mostly manifesting at approximately 2 weeks of initiation. Hepatotoxicity resulted in the majority (85.3%) of treatment discontinuations, while vision problems led to treatment modifications in half of the cases. Risk factors for all ADRs included age ≥60 years, females, illicit drug use, and comorbidities such as HIV-positive, diabetes, and chronic liver disease. Alcohol consumption was independently associated with hepatotoxicity. ADRs caused around one-third of interruptions exceeding 2 weeks (33.0%) and subsequently necessitated treatment restarts (34.5%). Conclusions: Understanding these various aspects contributes to improving the overall management of ADRs in TB treatment. Close ADR monitoring and reporting are essential to strengthen ADR management.https://journals.lww.com/10.4103/apjtm.apjtm_72_24adverse eventscutaneous reactionshepatotoxicitygastrointestinal disturbancesrisk factorstuberculosis
spellingShingle Ai Ling Oh
Mohd Makmor-Bakry
Farida Islahudin
Chuo Yew Ting
Swee Kim Chan
Siew Teck Tie
Adverse drug reactions of first-line antitubercular drugs: A retrospective study on characteristics, management, factors, and impacts
Asian Pacific Journal of Tropical Medicine
adverse events
cutaneous reactions
hepatotoxicity
gastrointestinal disturbances
risk factors
tuberculosis
title Adverse drug reactions of first-line antitubercular drugs: A retrospective study on characteristics, management, factors, and impacts
title_full Adverse drug reactions of first-line antitubercular drugs: A retrospective study on characteristics, management, factors, and impacts
title_fullStr Adverse drug reactions of first-line antitubercular drugs: A retrospective study on characteristics, management, factors, and impacts
title_full_unstemmed Adverse drug reactions of first-line antitubercular drugs: A retrospective study on characteristics, management, factors, and impacts
title_short Adverse drug reactions of first-line antitubercular drugs: A retrospective study on characteristics, management, factors, and impacts
title_sort adverse drug reactions of first line antitubercular drugs a retrospective study on characteristics management factors and impacts
topic adverse events
cutaneous reactions
hepatotoxicity
gastrointestinal disturbances
risk factors
tuberculosis
url https://journals.lww.com/10.4103/apjtm.apjtm_72_24
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