Evidence map›Paper›PMID 41412716›Full record

SynthesisThe European respiratory journal2026

Efficacy of isoniazid in paediatric tuberculosis: an individual participant data meta-analysis.

Agathe Béranger, Belén P Solans, Ryo Miyakawa, Helen McIlleron, Joel Tarning, Ira Shah, Blessed Winston Aruldhas, Binu Susan Mathew, Awewura Kwara, Charles A Peloquin and 19 more

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in The European respiratory journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

29 authors.

Agathe BérangerDepartment of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA.ORCID https://orcid.org/0000-0002-9751-8249
Belén P SolansDepartment of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA.
Ryo MiyakawaDepartment of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA.ORCID https://orcid.org/0000-0002-1729-0011
Helen McIlleronDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Joel TarningMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Ira ShahPediatric DR-TB Center of Excellence (State), Department of Pediatric Infectious Diseases, B.J. Wadia Hospital for Children, Mumbai, India.
Blessed Winston AruldhasDepartment of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India.
Binu Susan MathewDepartment of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India.
Awewura KwaraDepartment of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
Charles A PeloquinDepartment of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA.
Aparna MukherjeeDepartment of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, India.
Rakesh LodhaDepartment of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, India.
Paolo DentiDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Edmund V CapparelliSkaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.
Jennifer J KiserDepartment of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz, Aurora, CO, USA.
Adrie BekkerFamily Centre for Research with Ubuntu, Department of Paediatric and Child Health, Stellenbosch University, Cape Town, South Africa.
Chishala ChabalaDepartment of Paediatrics and Child Health, School of Medicine, University of Zambia, Lusaka, Zambia.ORCID https://orcid.org/0000-0002-5551-5752
Louise ChooMedical Research Council Clinical Trials Unit, University College London, London, UK.
Anna TurkovaMedical Research Council Clinical Trials Unit, University College London, London, UK.
Fajri GafarUnit of PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0002-0084-9018
Rovina RuslamiDepartment of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
Heda M NataprawiraDivision of Pediatric Respirology, Department of Child Health, Hasan Sadikin Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
Scott K HeysellDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
Tania A ThomasDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.ORCID https://orcid.org/0000-0002-3929-6369
Thirumurthy VelpandianDepartment of Ocular Pharmacology and Pharmacy, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Jeremy N DayDepartment of Clinical Microbiology and Infection, Royal Devon and Exeter University Hospital NHS Trust, Exeter, UK.
Nguyen Duc BangPham Ngoc Thach Hospital for Tuberculosis and Lung Disease, Ho Chi Minh City, Vietnam.
Kelly DooleyDivision of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA.ORCID https://orcid.org/0000-0001-9013-5256
Radojka M SavicDepartment of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA rada.savic@ucsf.edu.ORCID https://orcid.org/0000-0003-3143-5579

Funding

Urine Colorimetry for Tuberculosis Pharmacokinetics Evaluation in Children and AdultsR01AI137080 · NIAID · UNIVERSITY OF VIRGINIA · PI Scott K Heysell, Leonid Kagan · 2018 to 2026
$6.3M
NIAID NIH HHS R01 AI137080
6 · The paper itself

Abstract

backgroundIsoniazid is a cornerstone of management therapy for tuberculosis (TB). Our aim was to determine the association between isoniazid exposure and clinical outcomes, to develop a pharmacokinetic model, and to optimise the dosing regimen in children treated for drug-susceptible (DS)-TB.

methodsFor this individual participant data meta-analysis, PubMed was searched for observational studies, involving children (aged 0-18 years), being treated for DS-TB. The relationship between isoniazid exposure and clinical outcomes was analysed using a mixed effects logistic regression model. Pharmacokinetic parameters were described using non-linear mixed effects modelling. The pharmacokinetic target was the median adult area under the concentration-time curve at steady-state (AUC

resultsSix studies provided clinical outcomes, including 405 patients, of which 21% had unfavourable outcomes. 16 studies (1255 patients) were included in the pharmacokinetic model. Unfavourable outcomes were only related to lower body mass index (BMI) for age z-score (BAZ) (OR 0.96, 95% CI 0.93-0.99; p<0.05). Isoniazid exposure was impacted by

conclusionOur findings showed that the only predictor of unfavourable clinical outcomes was a lower BAZ. We support the current WHO-recommended dosing regimen for isoniazid. To equalise and attain our pharmacological target for all children, dosing regimens could be adjusted on NAT2 genotype and nutritional status.

Indexed as

Antitubercular AgentsIsoniazidTuberculosisAdolescentArea Under CurveArylamine N-AcetyltransferaseBody Mass IndexChildChild, PreschoolFemaleGenotypeHumansInfantInfant, NewbornLogistic ModelsMaleAntitubercular AgentsArylamine N-AcetyltransferaseIsoniazidNAT2 protein, human

Identifiers

PMID41412716

What OpenQuestion holds

Textmetadata
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Registered trials

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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.