Sadiq Shamiya, Khajuria Vijay, Tandon Vishal R, Mahajan Annil, Singh Jang B
Postgraduate, Department of Pharmacology and Therapeutics, GMC , Jammu, India .
Associate Professor, Department of Pharmacology and Therapeutics, GMC , Jammu, India .
J Clin Diagn Res. 2015 Oct;9(10):FC01-4. doi: 10.7860/JCDR/2015/13452.6652. Epub 2015 Oct 1.
Adverse drug reactions are very common among patients on anti-tubercular treatment alone or in combination with highly active antiretroviral therapy but comparatively studied very less. Hence, the current study was done to evalaute the adverse drug reaction (ADR) profile in patients receiving anti-tubercular treatment (ATT) and ATT with highly active antiretroviral therapy (HAART).
A one year prospective, cross-sectional observational study was undertaken using suspected adverse drug data collection form available under Pharmacovigilance Programme of India.
Seventy four patients receiving ATT & 32 patients on both ATT & HAART presented with 74 and 45 adverse drug events (ADE) respectively. Males were more affected than females in both the groups. DOTS category- 1 regimen was mostly responsible for ADE in both the groups. Epigastric pain was the most common ADE in TB patients, while anaemia was the most common presentation in TB with HIV group. On comparison, ADE rate of TB with HIV co-morbid patients was more (55.8%) than TB patients (0.36%) (p < 0.001). Urban population presented more with ADR in TB/HIV group unlike rural population in TB group (p<0.0001). Whereas, illiterate were more involved in TB group unlike literate in TB/HIV group (p<0.05). Type A reactions were more common in TB group (p < 0.001). Addition of drugs for the management of ADR events was more in TB/HIV group (p < 0.001) as compared to TB group. Rest all the parameters were comparable.
The study underscores that concomitant HAART and ATT, result in more ADRs in comparison to ATT alone demanding collaboration & integration of National AIDS Control programme and PvPI to enhance drug safety in this field.
药物不良反应在单独接受抗结核治疗或联合高效抗逆转录病毒治疗的患者中非常常见,但相关研究相对较少。因此,本研究旨在评估接受抗结核治疗(ATT)以及接受抗结核治疗与高效抗逆转录病毒治疗(HAART)联合治疗的患者的药物不良反应(ADR)情况。
采用印度药物警戒计划下的可疑药物不良反应数据收集表,进行了为期一年的前瞻性横断面观察研究。
74例接受抗结核治疗的患者和32例同时接受抗结核治疗与高效抗逆转录病毒治疗的患者分别出现了74例和45例药物不良事件(ADE)。两组中男性受影响的程度均高于女性。两组中的药物不良反应大多由直接观察短程治疗(DOTS)1类方案引起。上腹部疼痛是结核病患者中最常见的药物不良反应,而贫血是结核病合并艾滋病病毒感染组中最常见的表现。相比之下,结核病合并艾滋病病毒感染患者的药物不良事件发生率(55.8%)高于结核病患者(0.36%)(p<0.001)。与结核病组的农村人口不同,结核病/艾滋病病毒感染组的城市人口出现药物不良反应的情况更多(p<0.0001)。然而,与结核病/艾滋病病毒感染组的识字者不同,结核病组中不识字者受影响的情况更多(p<0.05)。A型反应在结核病组中更为常见(p<0.001)。与结核病组相比,结核病/艾滋病病毒感染组中因药物不良事件而添加的治疗药物更多(p<0.001)。其余所有参数均具有可比性。
该研究强调,与单独使用抗结核治疗相比,同时使用高效抗逆转录病毒治疗和抗结核治疗会导致更多的药物不良反应,这需要国家艾滋病控制计划和印度药物警戒计划进行合作与整合,以提高该领域的用药安全性。