4 months of @entity1215 compared with 9 months of isoniazid for the management of @entity9178 : a meta-analysis and cost-effectiveness study that focuses on compliance and liver XXXX .

@entity1 @entity137 @entity9178 @entity3109 @entity1578 @entity1215 @entity378
BACKGROUND: One-third of the world's population is infected with @entity378 , and 9 months of @entity3109 monotherapy is the treatment of choice for @entity9178 . However, this approach has been associated with hepatotoxicity and poor compliance. A shorter (4-month) @entity1215 regimen has been evaluated in recent clinical trials. METHODS: We performed a meta-analysis of the published studies to compare compliance, @entity137 , and cost-effectiveness between the 2 strategies. Pooled effects were calculated as risk ratios (RRs) by means of random-effects and fixed-effects models. RESULTS: Pooled data from 3586 @entity1 suggested that 4-month @entity1215 therapy was associated with a significant reduction in the risk of noncompletion (RR for random-effects model, 0.53; 95% confidence interval [CI], 0.44-0.63). Noncompletion rates were lower among @entity1 who received 4-month @entity1215 therapy (range, 8.6%-28.4%), compared with noncompletion rates among @entity1 who received 9-month isoniazid therapy (range, 24.1%-47.4%). Also, rates of hepatotoxicity (defined as grade 3 or 4 @entity1578 leading to drug discontinuation) were lower for @entity1 who received 4-month @entity1215 therapy (range, 0%-0.7%), compared with the corresponding rates for @entity1 who received 9-month isoniazid therapy (range, 1.4%-5.2%), and @entity1215 was associated with significant reduction in the risk of hepatotoxicity (RR for fixed-effects model, 0.12; 95% CI, 0.05-0.30). Notably, with the data from our meta-analysis, we calculated that the 4-month @entity1215 strategy is also cost-effective and results in  213 savings per @entity1 treated ( 90/ @entity1 when doctor fees are not included). CONCLUSIONS: The improved compliance, safety, and cost associated with the 4-month @entity1215 therapy suggest that the efficacy of this approach needs to be evaluated in detail. An extended posttreatment follow-up in future studies will clarify the unresolved issue of @entity378 reactivation rates.
