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Rifapentine-based regimen may allow for shorter course in tuberculosis

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Treatment with rifapentine-based regimen for 4 months was found to be noninferior to the standard 6-month regimen in patients with tuberculosis, according to a study.

In this open-label, phase 3, randomized, controlled trial, 2234 patients with newly diagnosed pulmonary tuberculosis were assessed for the primary outcome of survival free of tuberculosis at 12 months.

Patients were treated with rifapentine-based regimens for 4 months in addition to a standard 6-month regimen consisting of rifampin, isoniazid, pyrazinamide, and ethambutol. In 1 group of patients (n = 752), rifampin was replaced with rifapentine and in the other (n = 756), rifampin was replaced with rifapentine and ethambutol with moxifloxacin; 768 patients were in the control group.

An unfavorable outcome was found in 15.5% of patients receiving rifapentine with moxifloxacin compared with 14.6% of controls. Rifapentine without moxifloxacin was not noninferior to the control in either population.

Adverse events of grade ≥3 occurred during the study in 19.3%, 18.8%, and 14.3% of patients in the control group, rifapentine–moxifloxacin group, and the rifapentine group.

Dorman SE, Nahid P, Kurbatova EV, et al. Four-month rifapentine regimens with or without moxifloxacin for tuberculosis.