Effect of a modified regimen on drug-sensitive retreated pulmonary tuberculosis: A multicenter study in China

作者全名："Ge, Qiping; Ma, Yan; Zhang, Lijie; Ma, Liping; Zhao, Caiyan; Chen, Yuhui; Huang, Xuerui; Shu, Wei; Chen, Shengyu; Wang, Fei; Li, Bo; Han, Xiqin; Shi, Lian; Wang, Xin; Li, Youlun; Yang, Shangpeng; Cao, Wenli; Liu, Qianying; Chen, Ling; Wu, Chao; Ouyang, Bing; Wang, Furong; Li, Po; Wu, Xiang; Xi, Xiue; Leng, Xueyan; Zhang, Haiqing; Li, Hua; Li, Juan; Yang, Chengqing; Zhang, Peng; Cui, Hongzhe; Liu, Yuhong; Kong, Chengcheng; Sun, Zhaogang; Du, Jian; Gao, Weiwei"

作者地址："[Ge, Qiping; Zhang, Lijie; Huang, Xuerui; Shu, Wei; Han, Xiqin; Liu, Yuhong; Du, Jian; Gao, Weiwei] Capital Med Univ, Beijing Chest Hosp, Beijing TB & Thorac Tumor Res Inst, Dept TB, Beijing, Peoples R China; [Ma, Yan] China Acad Chinese Med Sci, Inst Basic Res Clin Med, Beijing, Peoples R China; [Ma, Yan] China Acad Chinese Med Sci, Inst Chinese Mat Med, Beijing, Peoples R China; [Zhang, Lijie; Shu, Wei] China CDC, Clin Ctr TB, Adm Off, Beijing, Peoples R China; [Ma, Liping] Henan Ctr Dis Control & Prevent, Dept TB Control, Zhengzhou, Henan, Peoples R China; [Zhao, Caiyan] Haerbin Chest Hosp, Dept TB, Haerbin, Peoples R China; [Chen, Yuhui] Ctr TB Control Guangdong Prov, Dept Outpatients, Guangzhou, Guangdong, Peoples R China; [Chen, Shengyu] Ctr TB Control Tianjin, Dept Outpatients, Tianjin, Peoples R China; [Wang, Fei] Zhejiang Ctr Dis Control & Prevent, Dept TB Control, Hangzhou, Zhejiang, Peoples R China; [Li, Bo] Beijing Ctr Dis Control & Prevent, Dept Outpatients, Beijing, Peoples R China; [Shi, Lian] Shenyang Chest Hosp, Dept TB, Shenyang, Liaoning, Peoples R China; [Wang, Xin] Heilongjiang Ctr Dis Control & Prevent, Dept TB Control, Haerbin, Heilongjiang, Peoples R China; [Li, Youlun] Chongqing Med Univ, Affiliated Hosp 1, Dept TB, Chongqing, Peoples R China; [Yang, Shangpeng] Jingzhou Hosp Infect Dis, Dept TB, Jingzhou, Hubei, Peoples R China; [Cao, Wenli] Beijing Geriatr Hosp, Dept Infect Dis, Beijing, Peoples R China; [Liu, Qianying] Peoples Liberat Army Gen Hosp, Med Ctr 8, Dept TB, Beijing, Peoples R China; [Chen, Ling] Zunyi Med Univ, Affiliated Hosp, Dept Resp & Crit Care Med, Zunyi, Guizhou, Peoples R China; [Wu, Chao] 3rd Peoples Hosp Zhenjiang, Dept TB, Zhenjiang, Jiangsu, Peoples R China; [Ouyang, Bing] Kunming 3rd Peoples Hosp, Dept TB, Kunming, Yunnan, Peoples R China; [Wang, Furong] 4th Hosp Inner Mongolia Autonomous Reg, Dept Med, Hohhot, Peoples R China; [Li, Bo] 3rd Hosp Baotou, Dept TB, Baotou, Peoples R China; [Wu, Xiang] Jingmen Ctr Dis Control & Prevent, Dept TB, Jingmen, Hubei, Peoples R China; [Xi, Xiue] Xinxiang Med Coll, Affiliated Hosp 1, Dept TB, Xinxiang, Peoples R China; [Leng, Xueyan] 3rd Hosp Qinhuangdao, Dept TB, Qinhuangdao, Hebei, Peoples R China; [Zhang, Haiqing] Xuzhou Hosp Infect Dis, Dept TB, Xuzhou, Jiangsu, Peoples R China; [Li, Hua] Linfen 3rd Peoples Hosp, Dept TB, Linfen, Shanxi, Peoples R China; [Li, Juan] Guangxi Zhuang Autonomous Reg Ctr Dis Control & Pr, Dept TB Control, Nangning, Peoples R China; [Yang, Chengqing] Wuhan TB Inst, Dept Resp & Crit Care Med, Wuhan, Hubei, Peoples R China; [Zhang, Peng] 4th Hosp Tangshan City, Dept TB, Tangshan, Hebei, Peoples R China; [Cui, Hongzhe] Yanbian Inst TB Prevent & Control, Dept TB Control, Yanbian, Jilin, Peoples R China; [Kong, Chengcheng; Sun, Zhaogang] Beijing TB & Thorac Tumor Res Inst, Translat Med Ctr, Beijing, Peoples R China"

通信作者："Du, J; Gao, WW (通讯作者)，Capital Med Univ, Beijing Chest Hosp, Beijing TB & Thorac Tumor Res Inst, Dept TB, Beijing, Peoples R China.; Sun, ZG (通讯作者)，Beijing TB & Thorac Tumor Res Inst, Translat Med Ctr, Beijing, Peoples R China."

来源：FRONTIERS IN PUBLIC HEALTH

ESI学科分类：SOCIAL SCIENCES, GENERAL

WOS号：WOS:000928776400001

JCR分区：Q2

影响因子：3

年份：2023

卷号：11

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：pulmonary tuberculosis; retreatment; modified regimen; recurrence; follow-up

摘要："Background and objective: Retreatment pulmonary tuberculosis (PTB) still accounts for a large proportion of tuberculosis, and the treatment outcome is unfavorable. The recurrence of retreatment PTB based on long-term follow-up has not been well demonstrated. This study aimed to evaluate e ect of a modified regimen on drug-sensitive retreated pulmonary tuberculosis. Methods: This multicenter cohort study was conducted in 29 hospitals from 23 regions of China from July 1, 2009, to December 31, 2020. Patients were divided into two treatment regimen groups including experimental group [modified regimen (4H-Rt2-E-Z-S(Lfx)/4H-Rt2-E)]and control group [standard regimen (2H-R-E-Z-S/6H-R-E or 3H-R-E-Z/6H-R-E)]. The patients enrolled were followed up of 56 months after successful treatment. We compared the treatment success rate, treatment failure rate, adverse reaction rate, and recurrence rate between two regimens. Multivariate Cox regression model was used to identify the potential risk factors for recurrence after successful treatment with proportional hazards assumptions tested for all variables. Results: A total of 381 patients with retreatment PTB were enrolled, including 244 (64.0%) in the experimental group and 137 (36.0%) in the control group. Overall, the treatment success rate was significant higher in the experimental group than control group (84.0 vs. 74.5%, P = 0.024); no di erence was observed in adverse reactions between the two groups (25.8 vs. 21.2%, P > 0.05). A total of 307 patients completed the 56 months of follow-up, including 205 with the modified regimen and 102 with the standard regimen. Among these, 10 cases (3.3%) relapsed, including 3 in the experimental group and 7 in the control group (1.5% vs 6.9%, P = 0.035). Reduced risks of recurrence were observed in patients treated with themodified regimen compared with the standard regimen, and the adjusted hazard ratio was 0.19 (0.04-0.77). Conclusion: The modified retreatment regimen had more favorable treatment e ects, including higher treatment success rate and lower recurrence rate in patients with retreated drug-sensitive PTB."

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