Individual research recommendation details

Recommendation ID

NG33/5

Question

For people with active, drug susceptible TB who experience treatment interruptions because of adverse events, particularly hepatotoxicity, what approach to re-establishing treatment is most
effective in reducing mortality and morbidity?

Any explanatory notes
(if applicable)

Why this is important
There is little evidence on re-establishing treatment after interruptions because of adverse events.This is key to ensuring treatment success without relapse or the emergence of drug resistance, but
avoiding further adverse events is also important. Randomised controlled trials are needed to compare approaches to re-establishing treatment for active, drug susceptible TB after it is
interrupted because of adverse events, particularly hepatotoxicity. These trials should assess mortality, treatment success or failure, rates of relapse, the recurrence of adverse events and the
emergence of drug resistance. Approaches evaluated could compare, for example, restarting regimens with lengthening their duration, as well as sequential reintroduction. Approaches should
vary depending on the proportion of doses missed and the stage of treatment (initial or continuation phase) in which the interruption occurred. Prospective observational cohort studies
with multivariable analyses may also be useful.

Source guidance details

Comes from guidance

Tuberculosis

Number

NG33

Date issued

January 2016

Other details