Evidence map›Paper›PMID 36966788›Full record

ArticleThe Lancet. Respiratory medicine2023

Completion, safety, and efficacy of tuberculosis preventive treatment regimens containing rifampicin or rifapentine: an individual patient data network meta-analysis.

Nicholas Winters, Robert Belknap, Andrea Benedetti, Andrey Borisov, Jonathon R Campbell, Richard E Chaisson, Pei-Chun Chan, Neil Martinson, Payam Nahid, Nigel A Scott and 5 more

Open access · greenAbstract readNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Respiratory medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
6.6field-weighted citation impact, top 2% 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

24 citing papers in PubMed, 34 citations in OpenAlex.

  1. Three Months of Weekly Rifapentine and Isoniazid Versus Four Months of Daily Rifampicin for Tuberculosis Infection: A Randomized Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Trial
  2. Trial
  3. Trial
  4. Breaking barriers: Implementation of a tuberculosis preventive treatment protocol among newly eligible populations with promising results.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Observational
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Treatment completion rates and adverse effects of three months of once-weekly isoniazid plus rifapentine for latent tuberculosis infection.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2025
    Article
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 3 countries.

Nicholas WintersDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Robert BelknapDenver Health and Hospital Authority and Division of Infectious Diseases, Department of Medicine, University of Colorado, Denver, CO, USA.
Andrea BenedettiDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Andrey BorisovUS Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jonathon R CampbellDepartment of Medicine, McGill University, Montreal, QC, Canada; Department of Global and Public Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada; McGill International TB Centre, Montreal, QC, Canada; Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Richard E ChaissonJohns Hopkins University School of Medicine, Center for Tuberculosis Research, Baltimore, MD, USA.
Pei-Chun ChanInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Division of Chronic Infectious Disease, Taiwan Centers for Disease Control, Taipei City, Taiwan.
Neil MartinsonJohns Hopkins University School of Medicine, Center for Tuberculosis Research, Baltimore, MD, USA.
Payam NahidUCSF Center for Tuberculosis, University of California, San Francisco, CA, USA.
Nigel A ScottUS Centers for Disease Control and Prevention, Atlanta, GA, USA.
Erin SizemoreUS Centers for Disease Control and Prevention, Atlanta, GA, USA.
Timothy R SterlingDepartment of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
M Elsa VillarinoCalifornia Department of Public Health, Sacramento, CA, USA.
Jann-Yuan WangDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Dick MenziesDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada. Electronic address: dick.menzies@mcgill.ca.
McGill University · CACenters for Disease Control and Prevention · USJohns Hopkins University · USCalifornia Department of Public Health · USDenver Health Medical Center · USNational Taiwan University · TWNational Taiwan University Hospital · TWUniversity of California, San Francisco · USVanderbilt University Medical Center · US

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

background3 months of weekly rifapentine plus isoniazid (3HP) and 4 months of daily rifampicin (4R) are recommended for tuberculosis preventive treatment. As these regimens have not been compared directly, we used individual patient data and network meta-analysis methods to compare completion, safety, and efficacy between 3HP and 4R.

methodsWe conducted a network meta-analysis of individual patient data by searching PubMed for randomised controlled trials (RCTs) published between Jan 1, 2000, and Mar 1, 2019. Eligible studies compared 3HP or 4R to 6 months or 9 months of isoniazid and reported treatment completion, adverse events, or incidence of tuberculosis disease. Deidentified individual patient data from eligible studies were provided by study investigators and outcomes were harmonised. Methods for network meta-analysis were used to generate indirect adjusted risk ratios (aRRs) and risk differences (aRDs) with their 95% CIs.

findingsWe included 17 572 participants from 14 countries in six trials. In the network meta-analysis, treatment completion was higher for people on 3HP than for those on 4R (aRR 1·06 [95% CI 1·02-1·10]; aRD 0·05 [95% CI 0·02-0·07]). For treatment-related adverse events leading to drug discontinuation, risks were higher for 3HP than for 4R for adverse events of any severity (aRR 2·86 [2·12-4·21]; aRD 0·03 [0·02-0·05]) and for grade 3-4 adverse events (aRR 3·46 [2·09-6·17]; aRD 0·02 [0·01-0·03]). Similar increased risks with 3HP were observed with other definitions of adverse events and were consistent across age groups. No difference in the incidence of tuberculosis disease between 3HP and 4R was found.

interpretationIn the absence of RCTs, our individual patient data network meta-analysis indicates that 3HP provided an increase in treatment completion over 4R, but was associated with a higher risk of adverse events. Although findings should be confirmed, the trade-off between completion and safety must be considered when selecting a regimen for tuberculosis preventive treatment.

fundingNone. TRANSLATIONS: For the French and Spanish translations of the abstract see Supplementary Materials section.

Indexed as

Latent TuberculosisTuberculosisAntitubercular AgentsDrug Therapy, CombinationHumansIsoniazidRifampinAntitubercular AgentsIsoniazidRifampinrifapentine

Identifiers

PMID36966788
PMCPMC11068309
OpenAlexW4360603216

What OpenQuestion holds

Textmetadata
LicenceTDM
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.