Cost-effectiveness of 3-months isoniazid and rifapentine compared to 9-months isoniazid for latent tuberculosis infection: a systematic review.
Cost-effectiveness of 3-months isoniazid and rifapentine compared to 9-months isoniazid for latent tuberculosis infection: a systematic review.
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3个月异烟肼联合利福喷丁方案与9个月异烟肼方案用于潜伏性结核感染的成本效益：一项系统评价
DOI：
10.1186/s12889-022-14766-6
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发表时间：
2022-12-07
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
--
作者：
我们进行了一项系统评价，检查了直接观察治疗的 3 个月异烟肼和利福喷汀（称为 3HP）疗程与直接观察或自我给药的 9 个月异烟肼治疗潜伏性结核感染的成本效益。 3HP 已被证明可以有效减少活动性结核病的进展，并且与其他短程治疗方案一样，与标准治疗方案（例如 9 个月的异烟肼）相比，具有更高的治疗完成率。如果了解利福喷汀较高的前期成本以及直接观察治疗所需的人力资源是否值得为改善结果进行投资，决策者将受益匪浅。我们检索了截至 2022 年 2 月的 PubMed、Embase、CINAHL、LILACS 和 Web of Science，搜索概念结合了潜伏性结核感染、直接观察的治疗以及成本或成本效益。纳入的研究采用英语或法语，针对具有潜伏性结核感染的人类受试者，提供了有关特定抗结核治疗方案的信息，有直接观察的治疗组，并描述了一些成本或经济数据的结果。我们排除了海报和摘要、多重耐药结核病的治疗以及联合检测和治疗策略。然后，我们将研究结果限制在检查直接观察的 3HP 进行比较的研究中。主要结果是直接观察 3HP 的成本和成本效益。我们确定了 3 项成本研究和 7 项成本效益研究。这 3 项成本研究将直接观察的 3HP 与直接观察的 9 个月异烟肼进行了比较。在 7 项成本效益研究中，4 项是基于高收入国家的建模研究；一项研究以加拿大北极地区结核病高发人群为模型，使用了来自该地区的经验成本计算数据；两项研究是在低收入、高艾滋病毒合并感染率人群中进行的。在五项研究中，在高收入国家中，直接观察的 3HP 与自行服用异烟肼 9 个月相比，具有增量成本效益比，从节省成本到增加 5418 美元/QALY。尽管证据有限，但现有证据表明 3HP 在低收入、艾滋病毒合并感染率高的环境中可能不具有成本效益。应继续评估方案规划和扩大规模的成本效益，并且可能会根据现有系统和当地情况（包括患病率以及患者的期望和偏好）而有所不同。在线版本包含可在 10.1186/s12889-022-14766-6 获取的补充材料。
We conducted a systematic review examining the cost effectiveness of a 3-month course of isoniazid and rifapentine, known as 3HP, given by directly observed treatment, compared to 9 months of isoniazid that is directly observed or self-administered, for latent tuberculosis infection. 3HP has shown to be effective in reducing progression to active tuberculosis and like other short-course regimens, has higher treatment completion rates compared to standard regimens such as 9 months of isoniazid. Decision makers would benefit from knowing if the higher up-front costs of rifapentine and of the human resources needed for directly observed treatment are worth the investment for improved outcomes. We searched PubMed, Embase, CINAHL, LILACS, and Web of Science up to February 2022 with search concepts combining latent tuberculosis infection, directly observed treatment, and cost or cost-effectiveness. Studies included were in English or French, on human subjects, with latent tuberculosis infection, provided information on specified anti-tubercular therapy regimens, had a directly observed treatment arm, and described outcomes with some cost or economic data. We excluded posters and abstracts, treatment for multiple drug resistant tuberculosis, and combined testing and treatment strategies. We then restricted our findings to studies examining directly-observed 3HP for comparison. The primary outcome was the cost and cost-effectiveness of directly-observed 3HP. We identified 3 costing studies and 7 cost-effectiveness studies. The 3 costing studies compared directly-observed 3HP to directly-observed 9 months of isoniazid. Of the 7 cost-effectiveness studies, 4 were modelling studies based in high-income countries; one study was modelled on a high tuberculosis incidence population in the Canadian Arctic, using empiric costing data from that setting; and 2 studies were conducted in a low-income, high HIV-coinfection rate population. In five studies, directly-observed 3HP compared to self-administered isoniazid for 9 months in high-income countries, has incremental cost-effectiveness ratios that range from cost-saving to $5418 USD/QALY gained. While limited, existing evidence suggests 3HP may not be cost-effective in low-income, high HIV-coinfection settings. Cost-effectiveness should continue to be assessed for programmatic planning and scale-up, and may vary depending on existing systems and local context, including prevalence rates and patient expectations and preferences. The online version contains supplementary material available at 10.1186/s12889-022-14766-6.
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DOI：
10.1183/09031936.00214014
发表时间：
2015-04
期刊：
The European respiratory journal
影响因子：
--
作者：
Lönnroth K;Migliori GB;Abubakar I;D'Ambrosio L;de Vries G;Diel R;Douglas P;Falzon D;Gaudreau MA;Goletti D;González Ochoa ER;LoBue P;Matteelli A;Njoo H;Solovic I;Story A;Tayeb T;van der Werf MJ;Weil D;Zellweger JP;Abdel Aziz M;Al Lawati MR;Aliberti S;Arrazola de Oñate W;Barreira D;Bhatia V;Blasi F;Bloom A;Bruchfeld J;Castelli F;Centis R;Chemtob D;Cirillo DM;Colorado A;Dadu A;Dahle UR;De Paoli L;Dias HM;Duarte R;Fattorini L;Gaga M;Getahun H;Glaziou P;Goguadze L;Del Granado M;Haas W;Järvinen A;Kwon GY;Mosca D;Nahid P;Nishikiori N;Noguer I;O'Donnell J;Pace-Asciak A;Pompa MG;Popescu GG;Robalo Cordeiro C;Rønning K;Ruhwald M;Sculier JP;Simunović A;Smith-Palmer A;Sotgiu G;Sulis G;Torres-Duque CA;Umeki K;Uplekar M;van Weezenbeek C;Vasankari T;Vitillo RJ;Voniatis C;Wanlin M;Raviglione MC
通讯作者：
Raviglione MC
DOI：
10.5588/ijtld.11.0504
发表时间：
2012-05-01
影响因子：
4
作者：
Chan, P-C.;Yang, C-H.;Huang, L-M.
通讯作者：
Huang, L-M.
DOI：
10.5588/ijtld.14.0674
发表时间：
2015-07-01
影响因子：
4
作者：
Bishara, H.;Ore, L.;Weiler-Ravell, D.
通讯作者：
Weiler-Ravell, D.
影响因子：
11.1
作者：
Marseille E;Larson B;Kazi DS;Kahn JG;Rosen S
通讯作者：
Rosen S
DOI：
10.5588/ijtld.18.0035
发表时间：
2018-11-01
影响因子：
4
作者：
Macaraig, M. M.;Jalees, M.;Burzynski, J.
通讯作者：
Burzynski, J.