Self-Administered Latent TB Treatment is Feasible

Self-administered, once-weekly treatment for latent tuberculosis (TB) may be an acceptable option in the United States, according to the authors of a non-inferiority trial.

While once-weekly isoniazid and rifapentine if effective for the treatment of latent TB, it is limited by requiring direct observation.
_______________________________________________________________________________________

RELATED CONTENT
USPSTF: Screen All At-Risk Adults for Latent Tuberculosis
Recognizing Risk Factors for Latent Tuberculosis
_______________________________________________________________________________________

In their study, the researchers randomly assigned 10002 adults from outpatient clinics in the US, Spain, Hong Kong, and South Africa, to once-weekly isoniazid and rifapentine by direct observation, self-administration with monthly monitoring, or self-administration with weekly text message reminders and monthly monitoring. The primary outcome of the study was treatment completion, defined as 11 or more doses within 16 weeks.

Overall, treatment completion was 87.2% in the direct-observation group, 74.0% in the self-administration group, and 76.4% in the self-administration-with-reminders group. In the US, treatment completion was 85.4% in the direct-observation group, 77.9% in the self-administration group, and 76.7% in the self-administration-with-reminders group.

“These results support using self-administered, once-weekly isoniazid and rifapentine to treat latent tuberculosis infection in the United States, and such treatment could be considered in similar settings when direct observation is not feasible,” the researchers concluded.

—Michael Potts

Reference:

Belknap R, Holland D, Feng P, et al. Self-administered versus directly observed once-weekly isoniazid and rifapentine treatment of latent tuberculosis infection: a randomized trial [published online November 7, 2017]. Ann Intern Med. doi: 10.7326/M17-1150.