Safety of Pyrazinamide for the Treatment of Tuberculosis in Older Patients Over 75 Years of Age: A Retrospective Monocentric Cohort Study.


Journal

Drugs & aging
ISSN: 1179-1969
Titre abrégé: Drugs Aging
Pays: New Zealand
ID NLM: 9102074

Informations de publication

Date de publication:
01 2021
Historique:
accepted: 17 10 2020
pubmed: 5 11 2020
medline: 25 2 2023
entrez: 4 11 2020
Statut: ppublish

Résumé

Pyrazinamide (PZA) has a controversial safety profile in older patients. We aimed to assess the frequency and risk factors for adverse drug reactions (ADRs) in patients over 75 years of age treated for tuberculosis with or without PZA. We conducted a retrospective monocentric study including patients aged over 75 years treated for active tuberculosis between 2008 and 2018. The frequency, type, seriousness, and causality assessment of ADRs to anti-tuberculosis treatment were compared between patients receiving PZA or not. Risk factors for ADRs were investigated using univariable and multivariable analyses by logistic regression. Among the 110 patients included, 54 (49.1%) received PZA (group 1) and 56 (50.9%) did not (group 2). ADRs to anti-tuberculosis drugs occurred in 31 patients (57.4%) in groups 1 and 15 (26.8%) in group 2 (p = 0.003). PZA-related ADRs occurred in 40.7% of exposed patients. Frequency of renal ADRs was higher in group 1 (9.3% vs 0%; p = 0.026). Rates of hepatic (18.5% vs 12.5%; p = 0.38), digestive (22.2% vs 8.9%; p = 0.054), and allergic (14.8% vs 5.4%; p = 0.12) ADRs were numerically higher in group 1 although the differences were not statistically significant. Serious ADRs occurred more frequently in group 1 (24.1% vs 8.9%; p = 0.03). The use of PZA was the only independent risk factor for ADRs to anti-tuberculosis drugs (odds ratio 3.75, 95% CI 1.5-9.6; p = 0.0056). No risk factors for PZA-related ADRs were identified. In older French patients, the use of PZA was associated with more frequent ADRs to anti-tuberculosis drugs.

Identifiants

pubmed: 33145702
doi: 10.1007/s40266-020-00811-9
pii: 10.1007/s40266-020-00811-9
doi:

Substances chimiques

Antitubercular Agents 0
Pyrazinamide 2KNI5N06TI

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

43-52

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Auteurs

Stella Rousset (S)

Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac, TSA 40031, 31059, Toulouse Cedex 9, France. rousset.st@chu-toulouse.fr.

Margaux Lafaurie (M)

Clinical Pharmacology Department, Toulouse University Hospital, 37 Allées Jules Guesde, 31073, Toulouse Cedex, France.
INSERM UMR 1027, University of Toulouse III, 37 Allées Jules Guesde, 31000, Toulouse, France.

Hélène Guet-Revillet (H)

Department of Bacteriology, Toulouse University Hospital, 330 Avenue de Grande-Bretagne; TSA 40031, 31059, Toulouse Cedex 9, France.

Caroline Protin (C)

Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac, TSA 40031, 31059, Toulouse Cedex 9, France.

Jean Le Grusse (J)

Tuberculosis Control Centre, Joseph Ducuing Hospital, 15 Rue de Varsovie, BP 53160, 31027, Toulouse Cedex 3, France.

Hélène Derumeaux (H)

Medical Information Department, Toulouse University Hospital, Place du Docteur Baylac, TSA 40031, 31059, Toulouse Cedex 9, France.

Peggy Gandia (P)

Clinical Pharmacokinetics Laboratory, Toulouse University Hospital, Place du Docteur Baylac, TSA 40031, 31059, Toulouse Cedex 9, France.

Fatemeh Nourhashemi (F)

Department of Geriatrics, Toulouse University Hospital, Place Lange, TSA 60033, 31059, Toulouse Cedex 9, France.
INSERM UMR 1027, University of Toulouse III, 37 Allées Jules Guesde, 31000, Toulouse, France.

Laurent Sailler (L)

Department of Internal Medicine, Place du Docteur Baylac, Toulouse University Hospital, TSA 40031, 31059, Toulouse cedex 9, France.

Agnès Sommet (A)

Clinical Pharmacology Department, Toulouse University Hospital, 37 Allées Jules Guesde, 31073, Toulouse Cedex, France.
INSERM UMR 1027, University of Toulouse III, 37 Allées Jules Guesde, 31000, Toulouse, France.

Pierre Delobel (P)

Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac, TSA 40031, 31059, Toulouse Cedex 9, France.
INSERM U1043, CNRS UMR 5282, Centre de Physiopathologie Toulouse-Purpan, Place du Docteur Baylac, TSA 40031, 31059, Toulouse Cedex 9, France.

Guillaume Martin-Blondel (G)

Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac, TSA 40031, 31059, Toulouse Cedex 9, France.
INSERM U1043, CNRS UMR 5282, Centre de Physiopathologie Toulouse-Purpan, Place du Docteur Baylac, TSA 40031, 31059, Toulouse Cedex 9, France.

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