Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen

Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in pat...
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Autor*in:	Mohan, Anant [verfasserIn] Bhatnagar, Anuj Gupta, Tarang Ujjalkumar, Das Kanswal, Sunita Velpandian, Thirumurthy Guleria, Randeep Singh, Urvashi B.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	Therapeutic drug monitoring Anti-tubercular therapy Retreatment regimen Pharmacokinetics

Anmerkung:	© The Author(s) under exclusive licence to The Korean Society of Pharmaceutical Sciences and Technology 2022

Übergeordnetes Werk:	Enthalten in: Journal of pharmaceutical investigation - Springer Science, 1983, 52(2022), 4 vom: 29. Mai, Seite 489-499
Übergeordnetes Werk:	volume:52 ; year:2022 ; number:4 ; day:29 ; month:05 ; pages:489-499

Links:	Volltext

DOI / URN:	10.1007/s40005-022-00577-9

Katalog-ID:	SPR047557087

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245	1	0	\|a Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen
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520			\|a Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. Therapeutic drug monitoring would prove useful for obtaining a favorable clinical outcome. $ C_{2hr} $ levels on Day 0 reflected drug levels achieved later and could be a good predictor of patient outcome.
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650		4	\|a Anti-tubercular therapy \|7 (dpeaa)DE-He213
650		4	\|a Retreatment regimen \|7 (dpeaa)DE-He213
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700	1		\|a Velpandian, Thirumurthy \|4 aut
700	1		\|a Guleria, Randeep \|4 aut
700	1		\|a Singh, Urvashi B. \|0 (orcid)0000-0001-8753-9743 \|4 aut
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allfields	10.1007/s40005-022-00577-9 doi (DE-627)SPR047557087 (SPR)s40005-022-00577-9-e DE-627 ger DE-627 rakwb eng Mohan, Anant verfasserin aut Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) under exclusive licence to The Korean Society of Pharmaceutical Sciences and Technology 2022 Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. Therapeutic drug monitoring would prove useful for obtaining a favorable clinical outcome. $ C_{2hr} $ levels on Day 0 reflected drug levels achieved later and could be a good predictor of patient outcome. Therapeutic drug monitoring (dpeaa)DE-He213 Anti-tubercular therapy (dpeaa)DE-He213 Retreatment regimen (dpeaa)DE-He213 Pharmacokinetics (dpeaa)DE-He213 Bhatnagar, Anuj aut Gupta, Tarang aut Ujjalkumar, Das aut Kanswal, Sunita aut Velpandian, Thirumurthy aut Guleria, Randeep aut Singh, Urvashi B. (orcid)0000-0001-8753-9743 aut Enthalten in Journal of pharmaceutical investigation Springer Science, 1983 52(2022), 4 vom: 29. Mai, Seite 489-499 (DE-627)684966700 (DE-600)2649383-4 2093-6214 nnns volume:52 year:2022 number:4 day:29 month:05 pages:489-499 https://dx.doi.org/10.1007/s40005-022-00577-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 52 2022 4 29 05 489-499
spelling	10.1007/s40005-022-00577-9 doi (DE-627)SPR047557087 (SPR)s40005-022-00577-9-e DE-627 ger DE-627 rakwb eng Mohan, Anant verfasserin aut Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) under exclusive licence to The Korean Society of Pharmaceutical Sciences and Technology 2022 Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. Therapeutic drug monitoring would prove useful for obtaining a favorable clinical outcome. $ C_{2hr} $ levels on Day 0 reflected drug levels achieved later and could be a good predictor of patient outcome. Therapeutic drug monitoring (dpeaa)DE-He213 Anti-tubercular therapy (dpeaa)DE-He213 Retreatment regimen (dpeaa)DE-He213 Pharmacokinetics (dpeaa)DE-He213 Bhatnagar, Anuj aut Gupta, Tarang aut Ujjalkumar, Das aut Kanswal, Sunita aut Velpandian, Thirumurthy aut Guleria, Randeep aut Singh, Urvashi B. (orcid)0000-0001-8753-9743 aut Enthalten in Journal of pharmaceutical investigation Springer Science, 1983 52(2022), 4 vom: 29. Mai, Seite 489-499 (DE-627)684966700 (DE-600)2649383-4 2093-6214 nnns volume:52 year:2022 number:4 day:29 month:05 pages:489-499 https://dx.doi.org/10.1007/s40005-022-00577-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 52 2022 4 29 05 489-499
allfields_unstemmed	10.1007/s40005-022-00577-9 doi (DE-627)SPR047557087 (SPR)s40005-022-00577-9-e DE-627 ger DE-627 rakwb eng Mohan, Anant verfasserin aut Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) under exclusive licence to The Korean Society of Pharmaceutical Sciences and Technology 2022 Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. Therapeutic drug monitoring would prove useful for obtaining a favorable clinical outcome. $ C_{2hr} $ levels on Day 0 reflected drug levels achieved later and could be a good predictor of patient outcome. Therapeutic drug monitoring (dpeaa)DE-He213 Anti-tubercular therapy (dpeaa)DE-He213 Retreatment regimen (dpeaa)DE-He213 Pharmacokinetics (dpeaa)DE-He213 Bhatnagar, Anuj aut Gupta, Tarang aut Ujjalkumar, Das aut Kanswal, Sunita aut Velpandian, Thirumurthy aut Guleria, Randeep aut Singh, Urvashi B. (orcid)0000-0001-8753-9743 aut Enthalten in Journal of pharmaceutical investigation Springer Science, 1983 52(2022), 4 vom: 29. Mai, Seite 489-499 (DE-627)684966700 (DE-600)2649383-4 2093-6214 nnns volume:52 year:2022 number:4 day:29 month:05 pages:489-499 https://dx.doi.org/10.1007/s40005-022-00577-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 52 2022 4 29 05 489-499
allfieldsGer	10.1007/s40005-022-00577-9 doi (DE-627)SPR047557087 (SPR)s40005-022-00577-9-e DE-627 ger DE-627 rakwb eng Mohan, Anant verfasserin aut Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) under exclusive licence to The Korean Society of Pharmaceutical Sciences and Technology 2022 Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. Therapeutic drug monitoring would prove useful for obtaining a favorable clinical outcome. $ C_{2hr} $ levels on Day 0 reflected drug levels achieved later and could be a good predictor of patient outcome. Therapeutic drug monitoring (dpeaa)DE-He213 Anti-tubercular therapy (dpeaa)DE-He213 Retreatment regimen (dpeaa)DE-He213 Pharmacokinetics (dpeaa)DE-He213 Bhatnagar, Anuj aut Gupta, Tarang aut Ujjalkumar, Das aut Kanswal, Sunita aut Velpandian, Thirumurthy aut Guleria, Randeep aut Singh, Urvashi B. (orcid)0000-0001-8753-9743 aut Enthalten in Journal of pharmaceutical investigation Springer Science, 1983 52(2022), 4 vom: 29. Mai, Seite 489-499 (DE-627)684966700 (DE-600)2649383-4 2093-6214 nnns volume:52 year:2022 number:4 day:29 month:05 pages:489-499 https://dx.doi.org/10.1007/s40005-022-00577-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 52 2022 4 29 05 489-499
allfieldsSound	10.1007/s40005-022-00577-9 doi (DE-627)SPR047557087 (SPR)s40005-022-00577-9-e DE-627 ger DE-627 rakwb eng Mohan, Anant verfasserin aut Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) under exclusive licence to The Korean Society of Pharmaceutical Sciences and Technology 2022 Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. Therapeutic drug monitoring would prove useful for obtaining a favorable clinical outcome. $ C_{2hr} $ levels on Day 0 reflected drug levels achieved later and could be a good predictor of patient outcome. Therapeutic drug monitoring (dpeaa)DE-He213 Anti-tubercular therapy (dpeaa)DE-He213 Retreatment regimen (dpeaa)DE-He213 Pharmacokinetics (dpeaa)DE-He213 Bhatnagar, Anuj aut Gupta, Tarang aut Ujjalkumar, Das aut Kanswal, Sunita aut Velpandian, Thirumurthy aut Guleria, Randeep aut Singh, Urvashi B. (orcid)0000-0001-8753-9743 aut Enthalten in Journal of pharmaceutical investigation Springer Science, 1983 52(2022), 4 vom: 29. Mai, Seite 489-499 (DE-627)684966700 (DE-600)2649383-4 2093-6214 nnns volume:52 year:2022 number:4 day:29 month:05 pages:489-499 https://dx.doi.org/10.1007/s40005-022-00577-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 52 2022 4 29 05 489-499
language	English
source	Enthalten in Journal of pharmaceutical investigation 52(2022), 4 vom: 29. Mai, Seite 489-499 volume:52 year:2022 number:4 day:29 month:05 pages:489-499
sourceStr	Enthalten in Journal of pharmaceutical investigation 52(2022), 4 vom: 29. Mai, Seite 489-499 volume:52 year:2022 number:4 day:29 month:05 pages:489-499
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Therapeutic drug monitoring Anti-tubercular therapy Retreatment regimen Pharmacokinetics
isfreeaccess_bool	false
container_title	Journal of pharmaceutical investigation
authorswithroles_txt_mv	Mohan, Anant @@aut@@ Bhatnagar, Anuj @@aut@@ Gupta, Tarang @@aut@@ Ujjalkumar, Das @@aut@@ Kanswal, Sunita @@aut@@ Velpandian, Thirumurthy @@aut@@ Guleria, Randeep @@aut@@ Singh, Urvashi B. @@aut@@
publishDateDaySort_date	2022-05-29T00:00:00Z
hierarchy_top_id	684966700
id	SPR047557087
language_de	englisch
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These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. 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author	Mohan, Anant
spellingShingle	Mohan, Anant misc Therapeutic drug monitoring misc Anti-tubercular therapy misc Retreatment regimen misc Pharmacokinetics Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen
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topic_title	Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen Therapeutic drug monitoring (dpeaa)DE-He213 Anti-tubercular therapy (dpeaa)DE-He213 Retreatment regimen (dpeaa)DE-He213 Pharmacokinetics (dpeaa)DE-He213
topic	misc Therapeutic drug monitoring misc Anti-tubercular therapy misc Retreatment regimen misc Pharmacokinetics
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title	Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen
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title_full	Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen
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author_browse	Mohan, Anant Bhatnagar, Anuj Gupta, Tarang Ujjalkumar, Das Kanswal, Sunita Velpandian, Thirumurthy Guleria, Randeep Singh, Urvashi B.
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title_sort	early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen
title_auth	Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen
abstract	Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. Therapeutic drug monitoring would prove useful for obtaining a favorable clinical outcome. $ C_{2hr} $ levels on Day 0 reflected drug levels achieved later and could be a good predictor of patient outcome. © The Author(s) under exclusive licence to The Korean Society of Pharmaceutical Sciences and Technology 2022
abstractGer	Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. Therapeutic drug monitoring would prove useful for obtaining a favorable clinical outcome. $ C_{2hr} $ levels on Day 0 reflected drug levels achieved later and could be a good predictor of patient outcome. © The Author(s) under exclusive licence to The Korean Society of Pharmaceutical Sciences and Technology 2022
abstract_unstemmed	Purpose Patients with pulmonary tuberculosis (PTB) who fail therapy or develop a relapse are initiated on a retreatment regimen. These patients are at high risk for adverse outcomes. This study aimed to assess the relationship between plasma levels of anti-tubercular drugs and therapy outcome in patients on retreatment. Methods Pharmacokinetics of retreatment regimen drugs [isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), ethambutol (EMB), and streptomycin (STM)] were compared between cured and not-cured patients using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 134 patients with PTB on a retreatment regimen. Results Of 134 patients, 108 were cured, 17 developed multi-drug resistant TB (MDR-TB), and 9 remained smear-positive after completion of the retreatment (8 months). Two-hour plasma levels ($ C_{2hr} $) at Day 0 were lower in ‘not cured’ subjects than ‘cured’ subjects and reflected the drug levels achieved later in the duration of retreatment. Notably, in the 26 ‘not cured’ subjects, $ C_{2hr} $ plasma levels after the first dose at Day 0 were significantly low (INH: 0.86 vs. 2.94 mg/L, p ≤ 0.002, RIF: 0.56 vs. 2.55 mg/L, p ≤ 0.003, PZA: 1.85 vs. 26.58 mg/L, p ≤ 0.001 and EMB: 0.72 vs. 1.53 mg/L, p ≤ 0.010). Conclusion Therapeutic failure in patients with PTB on a retreatment regimen is associated with lower plasma drug levels. Therapeutic drug monitoring would prove useful for obtaining a favorable clinical outcome. $ C_{2hr} $ levels on Day 0 reflected drug levels achieved later and could be a good predictor of patient outcome. © The Author(s) under exclusive licence to The Korean Society of Pharmaceutical Sciences and Technology 2022
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container_issue	4
title_short	Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen
url	https://dx.doi.org/10.1007/s40005-022-00577-9
remote_bool	true
author2	Bhatnagar, Anuj Gupta, Tarang Ujjalkumar, Das Kanswal, Sunita Velpandian, Thirumurthy Guleria, Randeep Singh, Urvashi B.
author2Str	Bhatnagar, Anuj Gupta, Tarang Ujjalkumar, Das Kanswal, Sunita Velpandian, Thirumurthy Guleria, Randeep Singh, Urvashi B.
ppnlink	684966700
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doi_str	10.1007/s40005-022-00577-9
up_date	2024-07-03T13:31:25.438Z
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Early pharmacokinetic evaluation of anti-tubercular treatment as a good indicator of treatment success in pulmonary tuberculosis patients on a retreatment regimen

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