TO DISCONTINUE OR TO WAIT?: INDICATIONS FOR DISCONTINUATION OF ANTI-TUBERCULOSIS DRUGS DUE TO ADVERSE EVENTS
https://doi.org/10.21292/2075-1230-2018-96-2-47-54
Abstract
The objective of the study: to define indications for discontinuation of a drug causing adverse reactions during chemotherapy in tuberculosis patients. The frequency, severity, and outcomes of adverse reactions with anti-tuberculosis drugs discontinued and not were analyzed in 435 new tuberculosis patients. The severity of AE was assessed using modified criteria of NCI CTCAE version 4.0 and DMID. In 69.2% of patients (95% CI 64.7-73.3%) AE resulted in the discontinuation of at least one drug and it was associated with the significant increase of the intensive phase duration. Severe AE (severity grades 3-4) were observed in 54.3% of patients (95% CI 49.6-58.9%). In 17.0% of cases, the discontinuation of drugs could have been avoided, in 20.9% the drug had to be discontinued due to the risk of complications and irreversible damage of organs as per the signs of grade 2 of severity. The continued in-take of anti-tuberculosis drugs in case of AE of severity grade 3-4 was associated with negative changes in 20 out of 62 cases (32.2%). Indications for discontinuation of anti-tuberculosis drugs in the intensive phase of treatment include grades 3-4 of severity, the risk of irreversible damage of an organ and life-threatening conditions. Discontinuation of the drug can be discussed in case of some moderate adverse events should all available conservative measures fail.
About the Authors
D. A. Ivаnovа
Moscow Municipal Scientific Practical Center of Tuberculosis Control, Moscow
Russian Federation
Candidate of Medical Sciences, Academic Secretary
Russian Federation
Candidate of Medical Sciences, Academic Secretary
S. E. Borisov
Moscow Municipal Scientific Practical Center of Tuberculosis Control, Moscow
Russian Federation
Doctor of Medical Sciences, Professor, Deputy Director for Research and Therapy
Russian Federation
Doctor of Medical Sciences, Professor, Deputy Director for Research and Therapy
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For citations:
Ivаnovа D.A., Borisov S.E. TO DISCONTINUE OR TO WAIT?: INDICATIONS FOR DISCONTINUATION OF ANTI-TUBERCULOSIS DRUGS DUE TO ADVERSE EVENTS. Tuberculosis and Lung Diseases. 2018;96(2):47-54. (In Russ.) https://doi.org/10.21292/2075-1230-2018-96-2-47-54
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