Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
Biostatistics Center, College of Management, Taipei Medical University, Taipei City, Taiwan; Graduate Institute of DataScience, College of Management, Taipei Medical University, Taipei, Taiwan; Department of Medical Education and Research, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan.
J Glob Antimicrob Resist. 2022 Jun;29:378-385. doi: 10.1016/j.jgar.2022.04.025. Epub 2022 May 6.
We conducted an updated network meta-analysis to elucidate the best regimen for latent tuberculosis infection (LTBI).
We searched the PubMed, Embase, and Cochrane Library databases on 16 August 2021 to perform an updated network meta-analysis. Only randomised controlled trials on populations with LTBI that reported the efficacy for preventing incident tuberculosis or the completion rates of treatment regimens were included. The Cochrane Collaboration tool was used to assess the risk of bias. We tested for possible global inconsistency with a χ test and local inconsistency by calculating inconsistency factors for each comparison in closed loops. The probability of each regimen being at each possible rank was estimated. Comparison-adjusted funnel plots were obtained to assess publication bias, and sensitivity analysis was performed. The major outcomes were the efficacy for preventing incident tuberculosis and the completion rates of treatment regimens.
We identified 27 studies that matched our inclusion criteria; the risk of bias was mostly low. Rifampicin for four months (RFMP-4) was the most likely to be effective (probability: 56.3%) and the second most likely treatment to be completed (probability: 22.4%). By applying a multidimensional scaling approach for ranking based on a scatterplot with the surface under the cumulative ranking values for efficacy and completion rates, RFMP-4 was deemed the best choice for treating LTBI. Similar results were demonstrated after sensitivity analysis.
This updated network meta-analysis revealed RFMP-4 to be the best choice for treating LTBI, per simultaneous consideration of efficacy and completion rates.
我们进行了一项更新的网络荟萃分析，以阐明潜伏性结核感染（LTBI）的最佳治疗方案。
我们于 2021 年 8 月 16 日检索了 PubMed、Embase 和 Cochrane Library 数据库，以进行更新的网络荟萃分析。仅纳入了针对 LTBI 人群的随机对照试验，这些试验报告了预防结核发病的疗效或治疗方案的完成率。使用 Cochrane 协作工具评估偏倚风险。我们通过 χ 检验检测了可能的全局不一致性，并通过计算每个闭环中比较的不一致因素来检测局部不一致性。估计了每个方案在每个可能等级的概率。通过获得比较调整的漏斗图来评估发表偏倚，并进行敏感性分析。主要结局是预防结核发病的疗效和治疗方案的完成率。
我们确定了 27 项符合纳入标准的研究；偏倚风险大多较低。为期 4 个月的利福平（RFMP-4）最有可能有效（概率：56.3%），也是最有可能完成治疗的方案（概率：22.4%）。通过应用多维尺度方法对疗效和完成率的累积排序值散点图进行排名，RFMP-4 被认为是治疗 LTBI 的最佳选择。在进行敏感性分析后也得到了类似的结果。
这项更新的网络荟萃分析表明，RFMP-4 是治疗 LTBI 的最佳选择，同时考虑了疗效和完成率。
