Tuberculosis can become resistant to treatment if pyrazinamide is used alone. 2020 Jan;30(1):39-47. doi: 10.1080/15376516.2019.1650150. The hepatotoxicity of pyrazinamide is both dose dependent (9) and idiosyncratic (10, 11). Treatment regimens of cases within 4 weeks preceding hepatotoxicity were compared with those of matched control subjects in comparable periods relative to the date of commencing treatment. 2016;16(6):533-44. doi: 10.2174/1566524016666160523143937. Yee D, Valiquette C, Pelletier M, Parisien I, Rocher I, Menzies D. Incidence of serious side effects from first-line antituberculosis drugs among patients treated for active tuberculosis.

Wong WM, Wu PC, Yuen MF, Cheng C, Yew W, Wong P, Tam C, Leung C, Lai C. Antituberculosis drug-related liver dysfunction in chronic hepatitis B infection. Controlled trial of 2, 4, and 6 months of pyrazinamide in 6-month, three-times-weekly regimens for smear-positive pulmonary tuberculosis, including an assessment of a combined preparation of isoniazid, rifampin, and pyrazinamide: results at 30 months. Endoplasmic reticulum (ER) stress; Hepatotoxicity; PERK-eIF2α-ATF4-CHOP pathway; Pyrazinamide; Sodium 4-phenylbutyrate. Pyrazinamide must be used with other TB medicines. Treatment lasts for 6 months for active TB, assuming responsiveness to antimicrobial therapy. However, the rate of drug-induced hepatitis in standard treatment for active TB (INH, RIF, PZA and EMB) is ∼3% 7. Multivariable conditional logistic regression analysis showed a significant association between hepatotoxicity and, respectively, pyrazinamide-containing regimens, other regimens, previous hepatotoxicity, and hepatitis B (see Table 3). Epub 2018 Oct 15. Hong Kong Chest Service/British Medical Research Council.

Conclusions: Adding pyrazinamide to isoniazid and rifampin increases the risk of hepatotoxicity appreciably. The adjusted odds ratio (95% confidence interval) of hepatotoxicity for regimens incorporating pyrazinamide, isoniazid, and/or rifampin relative to standard regimens was 2.8 (1.4–5.9). Among 141 matched control subjects, 111 (78.7%) received standard regimens, 27 (19.1%) received pyrazinamide-containing regimens, and 3 (2.1%) received others. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Jiao Z, Liu X, Ma Y, Ge Y, Zhang Q, Liu B, Wang H. Front Cell Dev Biol. In addition to treatment regimens, the following explanatory variables were included in univariate analysis: previous hepatotoxicity, smoking, habitual drinking, opiate abuse, past health including hepatitis B and hepatitis C, previous anti-TB treatment, and disease characteristics.

Pyrazinamide, the pyrazine analogue of nicotinamide, is an antituberculous agent. The authors would like to thank all colleagues in the Hong Kong Tuberculosis and Chest Service (Hong Kong, China) for their contribution to the computerized tuberculosis registry. Asymptomatic hepatitis in persons who received alternative preventive therapy with pyrazinamide and ofloxacin. Ordinary logistic regression analysis showed that hepatotoxicity from 12 or more weeks after starting treatment was significantly associated with males but not with age. Both fatal cases were males older than 49 years.  |  Despite the important role of pyrazinamide, relatively little is known about its hepatotoxicity. Two additional comments must be made as to the results presented. The risk of hepatotoxicity among patients given a particular regimen was calculated by dividing the number of cases given that regimen by the total number of patients given the same regimen within the entire cohort, which was estimated through the nested sample using sampling fractions. Sleep Breath. If early diagnosis of hepatotoxicity may reduce the case fatality rate, and the sensitivity of hepatitis symptoms is in the order of only 20% for serum ALT below 10 times the ULN, treatment with pyrazinamide may necessitate periodic monitoring of liver biochemistry in the presence of other risk factors such as chronic hepatitis B or C, and possibly advanced age and male sex. Pyrazinamide is an antibiotic that fights bacteria. In: Davies PDO, editor. Each case was matched by sex and age with three control subjects selected randomly from the rest of the cohort. The proportions of pulmonary TB (with or without coexisting extrapulmonary TB) and extrapulmonary TB were 88% and 14.8%, respectively (21).

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