Rifapentine outcome similar to rifampin in pulmonary TB
Treatment with a rifapentine regimen was comparable to the standard rifampin regimen in pulmonary tuberculosis, researchers from the Tuberculosis Trials Consortium have found.
“A major obstacle to tuberculosis control is the long duration of treatment required — at least 6 months — for drug-susceptible pulmonary tuberculosis,” the researchers wrote. “Highly potent tuberculosis regimens of shorter duration would facilitate treatment completion and improve individual and public health.”
According to the researchers, rifapentine (Priftin, Sanofi-Aventis) led to durable cures, without relapse, after 3 months in mouse models, but there are no data about its effect in humans as part of a TB combination treatment.
For this reason, researchers pooled data on 531 adults with sputum smear-positive pulmonary TB. Adults were randomly assigned to rifapentine 10 mg/kg/dose or rifampin 10 mg/kg/dose. The drug was administered 5 days a week for 8 weeks, along with isoniazid, pyrazinamide and ethambutol.
In the rifapentine group, 86.4% of the patients had negative cultures on solid media after treatment vs. 83.3% of patients in the rifampin group (95% CI, –4.3 to 10.5). In the rifapentine group, 67.9% of patients had negative cultures in liquid media after treatment vs. 65.1% of those in the rifampin group (95% CI, –6.9 to 12.4).
“Our study points out some of the challenges of directly extrapolating results from preclinical studies to human trials,” the researchers wrote. “Rifapentine remains a promising drug with potential for tuberculosis treatment shortening. … To continue to evaluate the potential for rifapentine to support shorter-course therapy for drug-susceptible tuberculosis, assessments of safety, activity and pharmacokinetics of higher daily rifapentine doses in patients with active tuberculosis is warranted.”
The researchers report no relevant financial disclosures.