Effectiveness and Safety of Short-Course Chemotherapy for Drug-Susceptible Pulmonary Tuberculosis: a Systematic Review and Meta-Analysis
https://doi.org/10.58838/2075-1230-2025-103-4-8-23
Abstract
The objective: A comparative analysis of effectiveness and safety of treatment for respiratory tuberculosis with confirmed drug susceptibility of M. tuberculosis using short-course regimens and a six-month regimen, based on the published data.
Subjects and Methods. A systematic search for randomized and quasi-randomized controlled clinical trials was conducted in databases from January 1, 2010 to January 21, 2025 using the keywords "pulmonary tuberculosis", "drug susceptibility" and "short-course regimens". Eight trials met the selection criteria and were included in the subsequent systematic review and meta-analysis. The primary outcomes focused on the risk of tuberculosis relapse and treatment failure, as well as development of serious adverse events during treatment with short-course regimens. Secondary outcomes included sputum conversion by week 8 of treatment, emergence of acquired drug resistance, and death during treatment with short-course regimens.
Results. According to the meta-analysis results, the risk of relapse was three times higher with short-course regimens versus a six-month regimen for drug-susceptible tuberculosis (RR 2.97, 95% CI (2.29-3.85). Short-course regimens slightly increase the risk of treatment failure (RR 1.47, 95% CI (1.27-1.71)) and provide no significant impact on death during treatment (RR 0.57, 95% CI (0.33-0.99)), incidence of serious adverse events (RR 0.90, 95% CI (0.81-1.01)), and sputum conversion by week 8 of treatment (RR 1.12, 95% CI (1.08-1.16)). Based on the meta-analysis results, it is impossible to draw a clear conclusion whether short-course regimens can lead to development of drug resistance (RR 0.45, 95% CI (0.12-1.73)).
About the Authors
V. A. Guseva
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Valeriya A. Guseva, Head of Telemedicine Center
2, 4 Dostoevskiy St., Moscow, 127473 Phone: +7 (495) 631-15-15
I. A. Vasilyeva
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health;
Pirogov Russian National Research Medical University, Russian Ministry of Health
Russian Federation
Russian Federation
Irina A. Vasilyeva, Doctor of Medical Sciences, Professor, Director, Head of Phthisiology Department, Clinical Medicine Institute, Pirogov Russian National Research Medical University, Russian Ministry of Health
2, 4 Dostoevskiy St., Moscow, 127473 Phone: +7 (495) 631-15-15
V. V. Testov
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Vadim V. Testov, Candidate of Medical Sciences, Deputy Director for Statistics and Reporting
2, 4 Dostoevskiy St., Moscow, 127473 Phone: +7 (495) 631-15-15
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Review
For citations:
Guseva V.A., Vasilyeva I.A., Testov V.V. Effectiveness and Safety of Short-Course Chemotherapy for Drug-Susceptible Pulmonary Tuberculosis: a Systematic Review and Meta-Analysis. Tuberculosis and Lung Diseases. 2025;103(4):8-23. (In Russ.) https://doi.org/10.58838/2075-1230-2025-103-4-8-23
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