Evidence map›Paper›PMID 27298314›Full record

SynthesisThorax2016

What are the most efficacious treatment regimens for isoniazid-resistant tuberculosis? A systematic review and network meta-analysis.

H R Stagg, R J Harris, H-A Hatherell, D Obach, H Zhao, N Tsuchiya, K Kranzer, V Nikolayevskyy, J Kim, M C Lipman and 1 more

Open access · hybridAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Thorax, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Treatment of Isoniazid-Resistant Pulmonary Tuberculosis.Tuberculosis and respiratory diseases · 2020
    Review
  8. Article
  9. Article
  10. Article
  11. Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2019
    Observational
  12. Article
  13. Article
  14. Isoniazid-monoresistant tuberculosis is associated with poor treatment outcomes in Durban, South Africa.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2017
    Article
  15. Isoniazid-resistant tuberculosis: a cause for concern?The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2017
    Review
  16. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 5 countries.

H R StaggResearch Department of Infection and Population Health, University College London, London, UK.
R J HarrisStatistics, Modelling and Economics Department, Public Health England, London, UK.
H-A HatherellResearch Department of Infection and Population Health, University College London, London, UK UCL CoMPLEX, Faculty of Mathematics and Physical Sciences, University College London, London, UK.
D ObachResearch Department of Infection and Population Health, University College London, London, UK.
H ZhaoRespiratory Diseases Department, National Infections Service, Public Health England, London, UK.ORCID http://orcid.org/0000-0002-1148-6240
N TsuchiyaDepartment of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
K KranzerNational and Supranational Mycobacterium Reference Laboratory, Research Centre Borstel, Borstel, Germany.
V NikolayevskyyNational Mycobacterium Reference Laboratory, Public Health England, London, UK Department of Medicine, Imperial College London, London, UK.
J KimResearch Department of Infection and Population Health, University College London, London, UK Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
M C LipmanUCL Respiratory, Division of Medicine, University College London, London, UK Royal Free London National Health Service Foundation Trust, London, UK.
I AbubakarResearch Department of Infection and Population Health, University College London, London, UK MRC Clinical Trials Unit, University College London, London, UK.
Public Health England · GBUniversity College London · GBMortimer Market Centre · GBMRC Clinical Trials Unit at UCL · GBNational Health Service · GBResearch Center Borstel - Leibniz Lung Center · DEThe Catholic University of Korea Incheon St. Mary's Hospital · KRTohoku University · JP

Funding

Department of Health PDF-2014-07-008
6 · The paper itself

Abstract

introductionConsensus on the best treatment regimens for patients with isoniazid-resistant TB is limited; global treatment guidelines differ. We undertook a systematic review and meta-analysis using mixed-treatment comparisons methodology to provide an up-to-date summary of randomised controlled trials (RCTs) and relative regimen efficacy.

methodsOvid MEDLINE, the Web of Science and EMBASE were mined using search terms for TB, drug therapy and RCTs. Extracted data were inputted into fixed-effects and random-effects models. ORs for all possible network comparisons and hierarchical rankings for different regimens were obtained.

results12 604 records were retrieved and 118 remained postextraction, representing 59 studies-27 standalone and 32 with multiple papers. In comparison to a baseline category that included the WHO-recommended regimen for countries with high levels of isoniazid resistance (rifampicin-containing regimens using fewer than three effective drugs at 4 months, in which rifampicin was protected by another effective drug at 6 months, and rifampicin was taken for 6 months), extending the duration of rifampicin and increasing the number of effective drugs at 4 months lowered the odds of unfavourable outcomes (treatment failure or the lack of microbiological cure; relapse post-treatment; death due to TB) in a fixed-effects model (OR 0.31 (95% credible interval 0.12-0.81)). In a random-effects model all estimates crossed the null.

conclusionsOur systematic review and network meta-analysis highlight a regimen category that may be more efficacious than the WHO population level recommendation, and identify knowledge gaps where data are sparse. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42014015025.

Indexed as

Drug Resistance, BacterialAntitubercular AgentsDrug Therapy, CombinationHumansIsoniazidMycobacterium tuberculosisPublication BiasRandomized Controlled Trials as TopicTuberculosisAntitubercular AgentsIsoniazidClinical EpidemiologyTuberculosis

Identifiers

PMID27298314
PMCPMC5036252
OpenAlexW2426444771

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.