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儿科结核病第一线治疗的不良事件:系统性审查和元分析

Michael Prodanuk^1,2, Sarah L Silverberg^1,2, Pierre-Philippe Piché-Renaud^1,2

¹Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

|March 24, 2025

概括

自2010年以来,世界卫生组织 (WHO) 建议儿童使用较高的结核病 (TB) 药物剂量,与更多不良事件 (AE) 有关. 需要进一步的研究,以了解这些增加的儿科结核病药物剂量的治疗耐受性.

科学领域:

儿童传染病儿童传染病
药物监督药物监督药物监督
结核病治疗方法结核病治疗方法

背景情况:

2010年,世界卫生组织 (WHO) 更新了指导方针,增加了儿科患者的一线结核病 (TB) 药物剂量.
对于这些较高的儿科结核病治疗剂量的安全性和耐受性存在担忧.

研究的目的:

确定在接受一线结核病治疗的儿童中不良事件 (AE) 的发生率.
评估2010年世卫组织的剂量建议是否改变了儿科结核病治疗的毒性概况.

主要方法:

进行了比例的系统审查和元分析.
搜索包括主要的数据库 (MEDLINE,Embase,Scopus,Cochrane) 和临床试验注册表.
包括报告儿童和青少年 (≤19岁) 结核病患者接受一线药物的副作用的研究.

主要成果:

分析了40项涉及5021名参与者的研究.
任何AE的总发病率与2010年WHO剂量相比 (26%) 与2010年之前的剂量相比 (8%) 显著高于2010年WHO剂量.
虽然整体肝毒性没有显著变化,但一些子组在2010年剂量时经历了肝毒性增加. 在1.2%的参与者中,AE导致治疗变化.

结论:

增加儿童的第一线结核病药物剂量与更高的不良事件发生率有关.
建议在儿童结核病治疗中对进一步的剂量升级保持谨慎,强调需要对治疗耐受性进行更多研究.
观察性研究中的出版偏见可能会限制研究结果的概括性.

关键词:

青少年青少年青少年不良事件不良事件不良事件孩子们的孩子们的孩子们的孩子们.治疗治疗治疗治疗治疗治疗结核病是一种肺结核病.

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