Systematic review and network meta-analysis of efficacy and safety of interventions for preventing anti-tuberculosis drug induced liver injury
Abstract Anti-tuberculosis drug induced liver injury (Anti-TB DILI) is the most common adverse events (AEs) necessitating therapy interruption but there is no preventing regimen. This study aimed to examine the efficacy and safety of herbs/alternative medicines for preventing anti-TB DILI. Relevant...
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| Format: | Article |
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Nature Portfolio
2023-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-46565-3 |
| _version_ | 1797559531358650368 |
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| author | Pattaraporn Akkahadsee Ratree Sawangjit Panumart Phumart Nathorn Chaiyakunapruk Duangkamon Sakloetsakun |
| author_facet | Pattaraporn Akkahadsee Ratree Sawangjit Panumart Phumart Nathorn Chaiyakunapruk Duangkamon Sakloetsakun |
| author_sort | Pattaraporn Akkahadsee |
| collection | DOAJ |
| description | Abstract Anti-tuberculosis drug induced liver injury (Anti-TB DILI) is the most common adverse events (AEs) necessitating therapy interruption but there is no preventing regimen. This study aimed to examine the efficacy and safety of herbs/alternative medicines for preventing anti-TB DILI. Relevant articles were identified through a systematic search in 5 international databases from inception till March 2022. All randomized controlled trials (RCT) assessing the effects of herbal or alternative medicines against anti-TB DILI were included. The network meta-analysis (NMA) was used to synthesize the evidence for preventing hepatotoxicity using a random-effects model. A total of 3423 patients from 14 RCTs were included. The NMA indicated that supplementation of Turmeric plus Tinospora cordifolia (RR 0.07; 95% CI 0.02 to 0.28), and N-acetyl cysteine (NAC) (RR 0.09; 95% CI 0.01 to 0.75) significantly reduced the incidence of anti-TB DILI compared with placebo. In addition, poly herbal product significantly reduced alkaline phosphatase (ALP) (MD − 21.80; 95% CI − 33.80 to − 9.80) and total bilirubin (Tbil) compared with placebo (MD − 0.51; 95% CI − 0.76 to − 0.26). There was no statistically significant difference in the occurrence of AEs in any intervention. In conclusion, Turmeric plus Tinospora cordifolia, NAC and poly-herbal product may provide benefit for preventing anti-TB DILI in TB patients. However, these findings are based on a small number of studies. Additional studies are warranted to confirm the findings. |
| first_indexed | 2024-03-10T17:46:43Z |
| format | Article |
| id | doaj.art-3c50f9e5795f4d6ba3bf0c2217d23b1f |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-10T17:46:43Z |
| publishDate | 2023-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-3c50f9e5795f4d6ba3bf0c2217d23b1f2023-11-20T09:29:06ZengNature PortfolioScientific Reports2045-23222023-11-0113111410.1038/s41598-023-46565-3Systematic review and network meta-analysis of efficacy and safety of interventions for preventing anti-tuberculosis drug induced liver injuryPattaraporn Akkahadsee0Ratree Sawangjit1Panumart Phumart2Nathorn Chaiyakunapruk3Duangkamon Sakloetsakun4Master Degree of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham UniversityClinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Mahasarakham UniversityDepartment of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen UniversityDepartment of Pharmacotherapy, College of Pharmacy, University of UtahDepartment of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Khon Kaen UniversityAbstract Anti-tuberculosis drug induced liver injury (Anti-TB DILI) is the most common adverse events (AEs) necessitating therapy interruption but there is no preventing regimen. This study aimed to examine the efficacy and safety of herbs/alternative medicines for preventing anti-TB DILI. Relevant articles were identified through a systematic search in 5 international databases from inception till March 2022. All randomized controlled trials (RCT) assessing the effects of herbal or alternative medicines against anti-TB DILI were included. The network meta-analysis (NMA) was used to synthesize the evidence for preventing hepatotoxicity using a random-effects model. A total of 3423 patients from 14 RCTs were included. The NMA indicated that supplementation of Turmeric plus Tinospora cordifolia (RR 0.07; 95% CI 0.02 to 0.28), and N-acetyl cysteine (NAC) (RR 0.09; 95% CI 0.01 to 0.75) significantly reduced the incidence of anti-TB DILI compared with placebo. In addition, poly herbal product significantly reduced alkaline phosphatase (ALP) (MD − 21.80; 95% CI − 33.80 to − 9.80) and total bilirubin (Tbil) compared with placebo (MD − 0.51; 95% CI − 0.76 to − 0.26). There was no statistically significant difference in the occurrence of AEs in any intervention. In conclusion, Turmeric plus Tinospora cordifolia, NAC and poly-herbal product may provide benefit for preventing anti-TB DILI in TB patients. However, these findings are based on a small number of studies. Additional studies are warranted to confirm the findings.https://doi.org/10.1038/s41598-023-46565-3 |
| spellingShingle | Pattaraporn Akkahadsee Ratree Sawangjit Panumart Phumart Nathorn Chaiyakunapruk Duangkamon Sakloetsakun Systematic review and network meta-analysis of efficacy and safety of interventions for preventing anti-tuberculosis drug induced liver injury Scientific Reports |
| title | Systematic review and network meta-analysis of efficacy and safety of interventions for preventing anti-tuberculosis drug induced liver injury |
| title_full | Systematic review and network meta-analysis of efficacy and safety of interventions for preventing anti-tuberculosis drug induced liver injury |
| title_fullStr | Systematic review and network meta-analysis of efficacy and safety of interventions for preventing anti-tuberculosis drug induced liver injury |
| title_full_unstemmed | Systematic review and network meta-analysis of efficacy and safety of interventions for preventing anti-tuberculosis drug induced liver injury |
| title_short | Systematic review and network meta-analysis of efficacy and safety of interventions for preventing anti-tuberculosis drug induced liver injury |
| title_sort | systematic review and network meta analysis of efficacy and safety of interventions for preventing anti tuberculosis drug induced liver injury |
| url | https://doi.org/10.1038/s41598-023-46565-3 |
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