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Anti-tuberculosis drug concentrations in tuberculosis patients with and without diabetes mellitus
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Journal Article
Anti-tuberculosis drug concentrations in tuberculosis patients with and without diabetes mellitus
2017
Overview
Purpose
The aim of the study was to compare plasma concentrations of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA) between tuberculosis (TB) patients with and without diabetes mellitus (DM).
Methods
Two-hour post-dosing concentrations of RMP, INH and PZA were determined in adult TB patients that were studied with (
n
= 452) and without DM (
n
= 1460), treated with a thrice-weekly regimen in India. Drug concentrations were estimated by HPLC.
Results
The median (IQR) INH [6.6 (3.9–10.0) and 7.8 (4.6–11.3)] and PZA [31.0 (22.3–38.0) and 34.1 (24.6–42.7)] microgram per milliliter concentrations were significantly lower in diabetic than non-diabetic TB patients (
p
< 0.001 for both drugs). Blood glucose was negatively correlated with plasma INH (
r
= −0.09,
p
< 0.001) and PZA (
r
= −0.092,
p
< 0.001). Multiple linear regression analysis showed RMP, INH and PZA concentrations were influenced by age and drug doses, INH and PZA by DM, RMP by alcohol use and PZA by gender and category of ATT. DM reduced INH and PZA concentrations by 0.8 and 3.0 μg/ml, respectively.
Conclusions
TB patients with DM had lower INH and PZA concentrations. Negative correlation between blood glucose and drug concentrations suggests delayed absorption/faster elimination of INH and PZA in the presence of elevated glucose.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
/ Antitubercular Agents - administration & dosage
/ Antitubercular Agents - blood
/ Antitubercular Agents - pharmacokinetics
/ Antitubercular Agents - therapeutic use
/ Biomedical and Life Sciences
/ Diabetes
/ Diabetes Mellitus - drug therapy
/ Drugs
/ Female
/ Humans
/ Isoniazid - administration & dosage
/ Isoniazid - pharmacokinetics
/ Male
/ Pharmacokinetics and Disposition
/ Pyrazinamide - administration & dosage
/ Pyrazinamide - pharmacokinetics
/ Pyrazinamide - therapeutic use
/ Rifampin - administration & dosage
/ Studies
