Side Effects of rifapentine: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major research findings

Rifapentine is an effective drug for preventing tuberculosis, but some side effects have been reported. 7 reported that in hemodialysis patients who received rifapentine and isoniazid combination therapy (3HP), the incidence of adverse events was as high as 69.2%. 4 investigated the correlation between rifapentine and isoniazid blood concentrations and adverse drug reactions. 3 proposed a genetic signature to predict adverse events from combination therapy with rifapentine and isoniazid.

Reasons for side effects

Rifapentine is a rifamycin antibiotic that is metabolized in the liver. In this process, CYP450 enzymes may be induced. CYP450 enzymes are involved in the metabolism of various drugs, and their induction can lead to drug interactions. 5 provides a detailed explanation of the side effects caused by the induction of CYP450 enzymes by rifamycin antibiotics. Rifapentine may also act on immune cells, which could be the cause of side effects. provides a detailed explanation of the side effects caused by the effect of rifapentine on metabolic enzymes.

Common side effects

Flu-like symptoms

Flu-like symptoms are the most common side effect of rifapentine. 5 , 1 , 2 reported flu-like symptoms due to rifapentine. These symptoms include fever, chills, muscle aches, and joint pain.

Liver dysfunction

Rifapentine can put a strain on the liver, leading to liver dysfunction. 7 showed no liver dysfunction in hemodialysis patients who received rifapentine and isoniazid combination therapy (3HP). However, 5 mentions the hepatotoxicity of rifamycin antibiotics. Liver dysfunction can cause symptoms such as jaundice, loss of appetite, nausea, and abdominal pain.

Skin reactions

Rifapentine can cause skin reactions. 5 mentions skin reactions caused by rifamycin antibiotics. Skin reactions include rash, itching, and hives.

Gastrointestinal symptoms

Rifapentine can cause gastrointestinal symptoms. 5 mentions gastrointestinal symptoms caused by rifamycin antibiotics. Gastrointestinal symptoms include nausea, vomiting, and diarrhea.

Countermeasures for side effects

Flu-like symptoms

If flu-like symptoms appear, consult your doctor and receive appropriate treatment. 2 mentions the management of flu-like symptoms caused by rifapentine. Antipyretics and analgesics may be prescribed to control symptoms.

Liver dysfunction

To prevent liver dysfunction due to rifapentine, it is important to undergo regular liver function tests. 5 mentions the management of hepatotoxicity caused by rifamycin antibiotics. If liver dysfunction is suspected, consult a doctor and receive appropriate treatment.

Skin reactions

If a skin reaction appears, consult your doctor and receive appropriate treatment. 5 mentions the management of skin reactions caused by rifamycin antibiotics. Antihistamines and steroid medications may be prescribed to control symptoms.

Gastrointestinal symptoms

If gastrointestinal symptoms appear, consult your doctor and receive appropriate treatment. 5 mentions the management of gastrointestinal symptoms caused by rifamycin antibiotics. Antiemetics and antidiarrheals may be prescribed to control symptoms.

Comparison between studies

Common points of research

Many studies have shown that rifapentine is effective in preventing tuberculosis. 14 summarizes the effectiveness of rifapentine-based tuberculosis preventive therapy. However, the risk of side effects is also pointed out.

Differences in research

Different studies report different incidences and types of side effects from rifapentine. 7 showed a higher incidence of adverse events in hemodialysis patients. 11 showed that side effects from rifapentine could be enhanced by the concomitant use of other drugs such as immunosuppressants. In addition, 3 proposed a genetic signature to predict adverse events from rifapentine. These research findings indicate that side effects from rifapentine vary depending on the patient and treatment situation.

Notes on application in real life

Rifapentine is an effective drug for preventing tuberculosis, but there is a risk of side effects. 16 emphasizes the importance of tuberculosis preventive therapy for healthcare workers. Therefore, it is important to consult a doctor and receive appropriate treatment when taking rifapentine. In particular, if side effects such as liver dysfunction or skin reactions occur, consult a doctor immediately. 19 provides a detailed explanation of the current status and challenges of tuberculosis preventive therapy in hemodialysis patients. Rifapentine may also interact with other drugs. Therefore, consult your doctor if you are taking other medications.

Limitations of current research

There are still many unknown aspects about the side effects of rifapentine. 6 investigated the perspectives of patients and healthcare professionals on the acceptance and completion of rifapentine-based tuberculosis preventive therapy. 15 investigated patient preferences for different tuberculosis preventive treatment regimen options. These studies did not address the details of side effects from rifapentine. Further research is needed on the mechanisms of side effects from rifapentine and methods of prevention.

Future research directions

Further research is needed on the mechanisms of side effects from rifapentine and methods of prevention. 17 discusses strategies to improve completion rates of rifapentine-based tuberculosis preventive therapy. Long-term safety and efficacy of rifapentine also need to be continuously investigated. 12 provides a detailed explanation of the safety and efficacy of rifapentine-based tuberculosis preventive therapy. More detailed research is also needed on the interactions between rifapentine and other drugs.

Conclusion

Rifapentine is an effective drug for preventing tuberculosis, but there is a risk of side effects. It is important to consult a doctor and receive appropriate treatment when taking rifapentine. If side effects occur, consult your doctor immediately. 9 discusses strategies to provide rifapentine-based tuberculosis preventive therapy to HIV patients. Future research is expected to deepen our understanding of the safety and efficacy of rifapentine.

Literature analysis of 24 papers
Positive Content
20
Neutral Content
0
Negative Content
3
Article Type
2
0
0
6
24
1.

Flu-like and Other Systemic Drug Reactions Among Persons Receiving Weekly Rifapentine Plus Isoniazid or Daily Isoniazid for Treatment of Latent Tuberculosis Infection in the PREVENT Tuberculosis Study.

Author: SterlingTimothy R, MoroRuth N, BorisovAndrey S, PhillipsElizabeth, ShepherdGillian, AdkinsonNewton Franklin, WeisStephen, HoChristine, VillarinoMargarita Elsa,

Hypotension
Syncope
Systemic drug reactions

Weekly rifapentine plus isoniazid for 3 months (3HP) was associated with a higher rate of clinically significant systemic drug reactions (SDR) compared to daily isoniazid for 9 months (9H). SDRs were mostly flu-like and occurred more frequently in white non-Hispanic individuals, females, older adults, and those with lower body mass index.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

2.

Symptoms and Systemic Drug Reactions in Persons Receiving Weekly Rifapentine Plus Isoniazid (3HP) Treatment for Latent Tuberculosis Infection.

Author: SadowskiClaire, BelknapRobert, HollandDavid P, MoroRuth N, ChenMichael P, WrightAlicia, MilletJoan Pau, CaylàJoan A, ScottNigel A, BorisovAndrey, GandhiNeel R

Systemic drug reactions

Rifapentine plus isoniazid (3HP) is a recommended treatment for latent tuberculosis infection (LTBI), but its effects on symptoms and side effects are not fully understood. This study aimed to determine patterns of symptom development and identify systemic drug reactions (SDRs) in patients taking 3HP. While more research is needed, this study provides valuable information about the potential side effects and symptom development associated with 3HP treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Whole-Blood 3-Gene Signature as a Decision Aid for Rifapentine-based Tuberculosis Preventive Therapy.

Author: HuangHung Ling, LeeJung Yu, LoYu Shu, LiuI Hsin, HuangSing Han, HuangYu Wei, LeeMeng Rui, LeeChih Hsin, ChengMeng Hsuan, LuPo Liang, WangJann Yuan, YangJinn Moon, ChongInn Wen

Personalized treatment
Systemic drug reaction

This study developed a 3-gene model for predicting systemic drug reaction (SDR) risk in patients receiving weekly rifapentine plus isoniazid for 12 doses (3HP) for latent tuberculosis infection (LTBI). The model achieved a sensitivity and specificity of 0.972 and 0.947, respectively, and worked well across different subgroups.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Isoniazid level and flu-like symptoms during rifapentine-based tuberculosis preventive therapy: A population pharmacokinetic analysis.

Author: LeeMing-Chia, FujitaYuito, MurakiShota, HuangHung-Ling, LeeChih-Hsin, WangJann-Yuan, IeiriIchiro

LTBI treatment
ADRs

The study aims to investigate the relationship between rifapentine or isoniazid concentration and adverse drug reactions (ADRs) in patients receiving the 3HP regimen for latent tuberculosis infection (LTBI).

Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Rifamycins--obstacles and opportunities.

Author: AristoffPaul A, GarciaGeorge A, KirchhoffPaul D, ShowalterH D

Improved rifamycin analogs
Reduced drug-drug interactions
Shorter treatment duration
Flu-like syndrome
Hepatotoxicity

Rifamycins, such as rifampin, are important drugs for treating tuberculosis (TB) but have limitations including drug resistance, hepatotoxicity, and drug interactions. This review discusses the potential for developing improved rifamycin analogs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Integrating 3HP-based tuberculosis preventive treatment into Zimbabwe's Fast Track HIV treatment model: experiences from a pilot study.

Author: MapingureMunyaradzi P, ZechJennifer M, Hirsch-MovermanYael, MsukwaMartin, HowardAndrea A, MakoniTatenda, GwanzuraClorata, ApolloTsitsi, SandyCharles, MusukaGodfrey N, RabkinMiriam

Adherence support
TPT delivery

This study evaluated the feasibility and acceptability of utilizing the Fast Track (FT) model to deliver tuberculosis preventive treatment (TPT) to people living with HIV (PLHIV) in Zimbabwe. The study found that aligning TPT and HIV visits, providing multi-month dispensing of TPT, and using phone-based support were feasible and acceptable.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Infection risk in patients undergoing treatment for inflammatory arthritis: non-biologics versus biologics.

Author: ChiuYing-Ming, ChenDer-Yuan

Effective treatment of inflammatory arthritis
Increased infection risk

This review examined the risk of infections in inflammatory arthritis patients treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), biologics (bDMARDs), including tumor necrosis factor (TNF) inhibitors and non-TNF inhibitors, or targeted synthetic (ts)DMARDs.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Three months of weekly rifapentine and isoniazid for treatment of Mycobacterium tuberculosis infection in HIV-coinfected persons.

Author: SterlingTimothy R, ScottNigel A, MiroJose M, CalvetGuilherme, La RosaAlberto, InfanteRosa, ChenMichael P, BenatorDebra A, GordinFred, BensonConstance A, ChaissonRichard E, VillarinoM Elsa,

Effective TB treatment
Well tolerated
Pneumonia

Weekly rifapentine and isoniazid under direct observation (3HP) was as effective and safe for treatment of latent Mycobacterium tuberculosis infection as 9 months of daily isoniazid (9H), and better tolerated.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

15.

Toward patient-centered tuberculosis preventive treatment: preferences for regimens and formulations in Lima, Peru.

Author: YuenCourtney M, MillonesAna K, GaleaJerome T, PumaDaniela, JimenezJudith, LeccaLeonid, BecerraMercedes C, KeshavjeeSalmaan

Treats tuberculosis

There is limited published literature about patient preferences for different tuberculosis preventive treatment regimen options, particularly from countries with high tuberculosis burdens.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

High Rate of Treatment Completion in Program Settings With 12-Dose Weekly Isoniazid and Rifapentine for Latent Mycobacterium tuberculosis Infection.

Author: SandulAmy L, NwanaNwabunie, HolcombeJ Mike, LobatoMark N, MarksSuzanne, WebbRisa, WangShu-Hua, StewartBrock, GriffinPhil, HuntGarrett, ShahNeha, MarcoAsween, PatilNaveen, MukasaLeonard, MoroRuth N, JerebJohn, MaseSundari, ChorbaTerence, Bamrah-MorrisSapna, HoChristine S

Greater completion rate

This article discusses the efficacy of a 12-week directly observed isoniazid and rifapentine (3HP) regimen for latent tuberculosis (LTBI) treatment, compared to the standard 9-month isoniazid regimen. While 3HP has shown comparable efficacy with higher completion rates, its effectiveness in routine healthcare settings needs further assessment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

18.

Improved treatment completion with shorter treatment regimens for latent tuberculous infection.

Author: MacaraigM M, JaleesM, LamC, BurzynskiJ

LTBI treatment

A retrospective analysis of patients treated for latent tuberculous infection (LTBI) in New York City found that patients were more likely to complete treatment when offered shorter regimens (4 months of daily rifampin or 3 months of once-weekly isoniazid and rifapentine) compared to the standard 9 months of daily isoniazid.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

19.

Completion and Adverse Drug Events of Latent Tuberculosis Infection Treatment in Patients Receiving Dialysis: Predictors and Impacts of Different Regimens in a Prospective Cohort Study.

Author: LinShu-Yung, FengJia-Yih, LeeChih-Yuan, LinYi-Chih, ChouYu-Hsiang, LinKuan-Yin, WeiYu-Feng, LinShu-Wen, ChangChin-Hao, WangPing-Huai, ShuChin-Chung, WangJann-Yuan, YuChong-Jen

The study compared two treatment regimens for latent tuberculosis infection (LTBI) in dialysis patients: 3 months of weekly rifapentine plus isoniazid (3HP) and 9 months of daily isoniazid (9H). 3HP had a higher completion rate (82%) than 9H (61%), but also a higher rate of adverse drug events (ADE) (29.2% vs. 10.8%). Diabetes mellitus and peritoneal dialysis were risk factors for ADE. Eosinophilia after 2 weeks of treatment was associated with severe ADE.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Impacts of 12-dose regimen for latent tuberculosis infection: Treatment completion rate and cost-effectiveness in Taiwan.

Author: HuangYi-Wen, YangShun-Fa, YehYen-Po, TsaoThomas Chang-Yao, TsaoShih-Ming

Higher treatment completion
Reduced costs
Undesirable side effects

Treatment for latent tuberculosis infection (LTBI) is crucial for eradicating tuberculosis (TB). Isoniazid is the standard treatment for LTBI but has a low completion rate due to its long duration and side effects. A shorter, weekly regimen of rifapentine/isoniazid (3HP) is being explored as an alternative with higher completion rates and lower costs.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Treatment for Tuberculosis Infection With 3 Months of Isoniazid and Rifapentine in New York City Health Department Clinics.

Author: StennisNatalie L, BurzynskiJoseph N, HerbertCheryl, NilsenDiana, MacaraigMichelle

Increases treatment completion

This study explores the potential of 3 months of once-weekly isoniazid and rifapentine administered under directly observed therapy (DOT) to improve treatment completion for tuberculosis infection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

[A study on the clinical efficacy of a combination regimen with levofloxacin and capreomycin in the treatment of multi-drug resistant pulmonary tuberculosis].

Author: ChenQi-liang, ChenLiang, YinJian-jun

MDR-TB treatment
Side effects

A combination therapy with levofloxacin (LVFX), capreomycin (CPM) and other second-line antituberculosis drugs was effective and safe for patients with multi-drug resistant pulmonary tuberculosis (MDR-TB).

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Chinese

23.

Treatment of Drug Susceptible Pulmonary Tuberculosis.

Author: ShinHong-Joon, KwonYong-Soo

TB treatment efficacy
Drug reactions
TB relapse

The standard short course regimen is highly effective against TB. However, the duration of treatment may need to be extended in some patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Safety and pharmacokinetics of escalating daily doses of the antituberculosis drug rifapentine in healthy volunteers.

Author: DooleyK E, Bliven-SizemoreE E, WeinerM, LuY, NuermbergerE L, HubbardW C, FuchsE J, MeliaM T, BurmanW J, DormanS E

Tuberculosis Treatment
CYP3A Induction

Rifapentine (RP T) is an antituberculosis drug that may shorten treatment duration. This study evaluated the maximal tolerated daily dose of RP T and its potential for cytochrome 3A4 induction and autoinduction. The results showed that RP T was well tolerated at doses as high as 20 mg/kg/day and its CYP 3A induction was robust.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

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