PMID- 25595441
OWN - NLM
STAT- MEDLINE
DCOM- 20151221
LR  - 20181202
IS  - 1873-281X (Electronic)
IS  - 1472-9792 (Print)
IS  - 1472-9792 (Linking)
VI  - 95
IP  - 2
DP  - 2015 Mar
TI  - Hepatotoxicity from antituberculous therapy in the elderly: a systematic review.
PG  - 112-22
LID - S1472-9792(14)20617-2 [pii]
LID - 10.1016/j.tube.2014.10.006 [doi]
AB  - BACKGROUND: Elderly persons have the highest rates of tuberculosis (TB) in the 
      United States compared to all other age groups. A systematic literature review 
      was conducted to determine if older age was a risk factor for hepatotoxicity 
      resulting from treatment with first-line drugs used to treat active (TB) and 
      latent tuberculosis (LTBI). METHODS: A systematic review of MEDLINE, Cochrane 
      Controlled Trial Registry, CINAHL((R)), and Science Citation Index Expanded (from 
      1970 to 2011) was performed to determine the risk of hepatotoxicity, comparing 
      those over 60 with those under 60. A meta-analysis was performed using a random 
      effects model along with log odds ratios and the chi-square test. FINDINGS: 
      Thirty-eight studies (40,034 participants; 1208 cases of hepatotoxicity) met the 
      selection criteria. For active TB, an overall mean effect of 0.277 (p = 0.024, 
      95% CI: 0.037-0.517) was observed, which is equivalent to an odds ratio of 1.32 
      (95% CI: 1.04-1.68). For LTBI, an overall mean effect of 1.42 (p < 0.001, 95% CI: 
      0.794-2.05) was observed, which translates to an odds ratio of 4.14 (95% CI: 
      2.21-7.74). INTERPRETATION: Our analysis revealed that patients older than 60 had 
      significantly more risk of hepatotoxicity. These studies suggest that a gentler 
      regimen of treatment for older individuals could benefit health outcomes in this 
      population of TB patients and minimize risks to the public's health.
CI  - Copyright (c) 2015 Elsevier Ltd. All rights reserved.
FAU - Hosford, Jennifer D
AU  - Hosford JD
AD  - Southeastern National Tuberculosis Center, Department of Medicine, University of 
      Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of 
      Florida, Gainesville, FL, USA.
FAU - von Fricken, Michael E
AU  - von Fricken ME
AD  - Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA; 
      Department of Environmental and Global Health, University of Florida, 
      Gainesville, FL, USA.
FAU - Lauzardo, Michael
AU  - Lauzardo M
AD  - Southeastern National Tuberculosis Center, Department of Medicine, University of 
      Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of 
      Florida, Gainesville, FL, USA.
FAU - Chang, Myron
AU  - Chang M
AD  - Department of Biostatistics, University of Florida, Gainesville, FL, USA.
FAU - Dai, Yunfeng
AU  - Dai Y
AD  - Department of Biostatistics, University of Florida, Gainesville, FL, USA.
FAU - Lyon, Jennifer A
AU  - Lyon JA
AD  - Biomedical and Health Information Services, University of Florida, Gainesville, 
      FL, USA.
FAU - Shuster, John
AU  - Shuster J
AD  - Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, 
      USA.
FAU - Fennelly, Kevin P
AU  - Fennelly KP
AD  - Southeastern National Tuberculosis Center, Department of Medicine, University of 
      Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of 
      Florida, Gainesville, FL, USA. Electronic address: 
      Kevin.Fennelly@medicine.ufl.edu.
LA  - eng
GR  - UL1 TR000064/TR/NCATS NIH HHS/United States
GR  - UL1 TR001427/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20141218
PL  - Scotland
TA  - Tuberculosis (Edinb)
JT  - Tuberculosis (Edinburgh, Scotland)
JID - 100971555
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Antitubercular Agents/*adverse effects/therapeutic use
MH  - Chemical and Drug Induced Liver Injury/*etiology
MH  - Humans
MH  - Latent Tuberculosis/drug therapy
MH  - Risk Factors
MH  - Tuberculosis/drug therapy
PMC - PMC4640443
MID - NIHMS725534
OTO - NOTNLM
OT  - Aging
OT  - Antituberculous
OT  - Elderly
OT  - Hepatotoxicity
OT  - Latent tuberculosis
OT  - Systematic review
OT  - Therapy
OT  - Toxicity
OT  - Treatment
OT  - Tuberculosis
COIS- Conflicts of interest: The authors have no conflicts of interest with the 
      findings from this study.
EDAT- 2015/01/18 06:00
MHDA- 2015/12/22 06:00
PMCR- 2015/11/10
CRDT- 2015/01/18 06:00
PHST- 2014/09/30 00:00 [received]
PHST- 2014/10/14 00:00 [accepted]
PHST- 2015/01/18 06:00 [entrez]
PHST- 2015/01/18 06:00 [pubmed]
PHST- 2015/12/22 06:00 [medline]
PHST- 2015/11/10 00:00 [pmc-release]
AID - S1472-9792(14)20617-2 [pii]
AID - 10.1016/j.tube.2014.10.006 [doi]
PST - ppublish
SO  - Tuberculosis (Edinb). 2015 Mar;95(2):112-22. doi: 10.1016/j.tube.2014.10.006. 
      Epub 2014 Dec 18.