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Dr. Bryan Li, Dr. Gerry Kwok, Dr. Thomas Yau, 07 Aug 2019

Case 1: A 59-year-old gentleman with advanced HCC was referred to our centre for management. He had a history of diabetes, hypertension and ischaemic heart disease. He was a nondrinker and not a carrier of hepatitis B or C.

Case 2: A 65-year-old man with a history of alcoholic cirrhosis and oesophageal varices was found to have rising AFP levels on routine follow-up. He also had a 3-year history of diabetes and was on diet control, with an HbA1c of 6.2 percent and fasting glucose of 6.8 mmol/L. He did not need any diabetic medications.

Short-course TB treatment improves completion rates in paediatric patients

10 Feb 2018

The use of shorter treatment regimens in children with tuberculosis (TB) infection leads to increased rates of completion and fewer adverse events (AEs) when compared with 9 months of daily isoniazid (9H) treatment, a study has shown.

Researchers reviewed the medical records of 667 children with TB infection (median age 8 years; 50.8 percent female) who received 9H (n=252), 4 months of daily rifampin (4R; n=132) or 3 months of once-weekly isoniazid and rifapentine (3HP; n=283).

The 4R and 9H regimens could be administered by families (self-administered therapy [SAT]) or as directly observed preventive therapy (DOPT). On the other hand, 3HP was always administered under DOPT.

Completion rates were highest with 3HP (96.8 percent) and lowest with 9H under SAT (52.6 percent; odds ratio [OR], 27.4; 95 percent CI, 11.8–63.7). When administered under DOPT, 9H had a completion rate of 89 percent (vs 9H under SAT: OR, 7.11; 3.54–14.28). The rates did not significantly differ between 3HP and 4R under DOPT (OR, 1.12; 0.14–9.09).

On multivariable regression analysis, completion of therapy was associated with the following factors: receipt of medication under DOPT (OR, 5.72; 3.47–9.43), increasing age (OR, 1.09; 1.02–1.17) and the absence of any AE (OR, 1.70; 0.26–0.60).

There were 62 children (9.3 percent) overall with complaints of any AE, which occurred frequently in the 9H group (OR, 2.51; 1.48–4.32). Hepatotoxicity was reported in two (0.9 percent) children in the 9H group in none in the 3HP and 4R groups.

The present data indicate that the 3HP and 4R regimens are well tolerated and associated with significantly higher completion rates compared with 9H, with the effectiveness of these short-course regimens being high in the short-term, researchers said.

“We hope that the coming years will see a shift in TB infection diagnosis to IGRAs to enable treatment to target the children who would receive the most benefit from therapy, and that increased data on 3HP pharmacokinetics and more child-friendly formulations of 3HP will enable this shorter regimen to be used in the most vulnerable paediatric population: infants and young children,” they added.

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Most Read Articles
02 Jul 2019
New drug applications approved by US FDA as of 16 - 30 June 2019 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approval. Supplemental approvals may have occurred since the original approval date.
3 days ago
Tofogliflozin is safe and effective for elderly patients with type 2 diabetes mellitus (T2DM), regardless of insulin and oral antidiabetic drugs, reports a new Japan study.
05 Aug 2019
Use of alpha blockers in the treatment of hypertension in women is associated with an increased risk of hypotension and related events as compared with other blood pressure-lowering drugs, as reported in a recent study.
Dr. Bryan Li, Dr. Gerry Kwok, Dr. Thomas Yau, 07 Aug 2019

Case 1: A 59-year-old gentleman with advanced HCC was referred to our centre for management. He had a history of diabetes, hypertension and ischaemic heart disease. He was a nondrinker and not a carrier of hepatitis B or C.

Case 2: A 65-year-old man with a history of alcoholic cirrhosis and oesophageal varices was found to have rising AFP levels on routine follow-up. He also had a 3-year history of diabetes and was on diet control, with an HbA1c of 6.2 percent and fasting glucose of 6.8 mmol/L. He did not need any diabetic medications.