PMID- 37963954
OWN - NLM
STAT- MEDLINE
DCOM- 20231116
LR  - 20231124
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 13
IP  - 1
DP  - 2023 Nov 14
TI  - Systematic review and network meta-analysis of efficacy and safety of 
      interventions for preventing anti-tuberculosis drug induced liver injury.
PG  - 19880
LID - 10.1038/s41598-023-46565-3 [doi]
LID - 19880
AB  - Anti-tuberculosis drug induced liver injury (Anti-TB DILI) is the most common 
      adverse events (AEs) necessitating therapy interruption but there is no 
      preventing regimen. This study aimed to examine the efficacy and safety of 
      herbs/alternative medicines for preventing anti-TB DILI. Relevant articles were 
      identified through a systematic search in 5 international databases from 
      inception till March 2022. All randomized controlled trials (RCT) assessing the 
      effects of herbal or alternative medicines against anti-TB DILI were included. 
      The network meta-analysis (NMA) was used to synthesize the evidence for 
      preventing hepatotoxicity using a random-effects model. A total of 3423 patients 
      from 14 RCTs were included. The NMA indicated that supplementation of Turmeric 
      plus Tinospora cordifolia (RR 0.07; 95% CI 0.02 to 0.28), and N-acetyl cysteine 
      (NAC) (RR 0.09; 95% CI 0.01 to 0.75) significantly reduced the incidence of 
      anti-TB DILI compared with placebo. In addition, poly herbal product 
      significantly reduced alkaline phosphatase (ALP) (MD - 21.80; 95% CI - 33.80 to 
      - 9.80) and total bilirubin (Tbil) compared with placebo (MD - 0.51; 95% CI 
      - 0.76 to - 0.26). There was no statistically significant difference in the 
      occurrence of AEs in any intervention. In conclusion, Turmeric plus Tinospora 
      cordifolia, NAC and poly-herbal product may provide benefit for preventing 
      anti-TB DILI in TB patients. However, these findings are based on a small number 
      of studies. Additional studies are warranted to confirm the findings.
CI  - (c) 2023. The Author(s).
FAU - Akkahadsee, Pattaraporn
AU  - Akkahadsee P
AD  - Master Degree of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, 
      MahaSarakham, Thailand.
FAU - Sawangjit, Ratree
AU  - Sawangjit R
AD  - Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), 
      Mahasarakham University, MahaSarakham, Thailand. ratree.m@msu.ac.th.
FAU - Phumart, Panumart
AU  - Phumart P
AD  - Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical 
      Sciences, Khon Kaen University, Khon Kaen, Thailand.
FAU - Chaiyakunapruk, Nathorn
AU  - Chaiyakunapruk N
AD  - Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake 
      City, UT, USA.
AD  - IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, 
      UT, USA.
FAU - Sakloetsakun, Duangkamon
AU  - Sakloetsakun D
AD  - Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Khon 
      Kaen University, Khon Kaen, Thailand.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20231114
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Humans
MH  - *Antitubercular Agents/adverse effects
MH  - Network Meta-Analysis
MH  - *Chemical and Drug Induced Liver Injury/drug therapy/etiology/prevention & 
      control
PMC - PMC10645982
COIS- The authors declare no competing interests.
EDAT- 2023/11/15 00:41
MHDA- 2023/11/16 06:44
PMCR- 2023/11/14
CRDT- 2023/11/14 23:28
PHST- 2022/11/25 00:00 [received]
PHST- 2023/11/02 00:00 [accepted]
PHST- 2023/11/16 06:44 [medline]
PHST- 2023/11/15 00:41 [pubmed]
PHST- 2023/11/14 23:28 [entrez]
PHST- 2023/11/14 00:00 [pmc-release]
AID - 10.1038/s41598-023-46565-3 [pii]
AID - 46565 [pii]
AID - 10.1038/s41598-023-46565-3 [doi]
PST - epublish
SO  - Sci Rep. 2023 Nov 14;13(1):19880. doi: 10.1038/s41598-023-46565-3.