OBJECTIVE: To compare the efficacy of British Thoracic Society and American Thoracic Society guidelines for reintroduction of anti-tuberculous therapy after drug-induced liver injury, and to assess the ease of administration of each guideline on a scale of 1-10. METHODS: The randomised prospective interventional study was conducted at the Department of Medicine and Pulmonology, Dow University of Health Sciences, Karachi, from December 2011 to November 2013. Patients with anti-tuberculous therapy drug-induced liver injury were selected. Hepatotoxic anti-tuberculous therapy was stopped and modified anti-tuberculous therapy was started. Patients were followed weekly till clinical and biochemical parameters got stabilised. After stabilisation, the patients were randomised to one of the two groups to receive re-introduction of anti-tuberculous therapy under the guidelines of British Thoracic Society (Group I) or those of American Thoracic Society (Group II). Means of the groups were analysed by Student's t test and proportions were compared by chi-square test. Multivariate analysis was done for age, body mass index and serum albumin for recurrence of drug-induced liver injury after the re-introduction. P value < 0.05 was taken as significant. RESULTS: Of the total 325 patients, 163 (50.15%) were in Group I, while 162 (49.84%) were in Group II. The frequency of recurrence of drug-induced liver injury in Group I was 16 (9.8%) and in Group II it was 18 (11.1%).There was no statistically significant difference between the two groups (p < 0.7). Age was positively related with drug-induced liver injury, while body mass index and serum albumin were negatively associated. CONCLUSION: There was no significant difference between the two major guidelines though the American Thoracic Society guideline was easier to follow.
RCT Entities:
OBJECTIVE: To compare the efficacy of British Thoracic Society and American Thoracic Society guidelines for reintroduction of anti-tuberculous therapy after drug-induced liver injury, and to assess the ease of administration of each guideline on a scale of 1-10. METHODS: The randomised prospective interventional study was conducted at the Department of Medicine and Pulmonology, Dow University of Health Sciences, Karachi, from December 2011 to November 2013. Patients with anti-tuberculous therapy drug-induced liver injury were selected. Hepatotoxic anti-tuberculous therapy was stopped and modified anti-tuberculous therapy was started. Patients were followed weekly till clinical and biochemical parameters got stabilised. After stabilisation, the patients were randomised to one of the two groups to receive re-introduction of anti-tuberculous therapy under the guidelines of British Thoracic Society (Group I) or those of American Thoracic Society (Group II). Means of the groups were analysed by Student's t test and proportions were compared by chi-square test. Multivariate analysis was done for age, body mass index and serum albumin for recurrence of drug-induced liver injury after the re-introduction. P value < 0.05 was taken as significant. RESULTS: Of the total 325 patients, 163 (50.15%) were in Group I, while 162 (49.84%) were in Group II. The frequency of recurrence of drug-induced liver injury in Group I was 16 (9.8%) and in Group II it was 18 (11.1%).There was no statistically significant difference between the two groups (p < 0.7). Age was positively related with drug-induced liver injury, while body mass index and serum albumin were negatively associated. CONCLUSION: There was no significant difference between the two major guidelines though the American Thoracic Society guideline was easier to follow.
Authors: Muhammed Shiraz Moosa; Gary Maartens; Hannah Gunter; Shaazia Allie; Mohamed F Chughlay; Mashiko Setshedi; Sean Wasserman; David F Stead; Karen Cohen Journal: South Afr J HIV Med Date: 2022-06-14 Impact factor: 1.835