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Three months of once-weekly isoniazid plus rifapentine (3HP) in treating latent tuberculosis infection is feasible in patients with rheumatoid arthritis
  1. Yi-Ming Chen1,2,3,
  2. Tsai-Ling Liao1,2,
  3. Hsin-Hua Chen1,2,3,
  4. Der-Yuan Chen4,5,6
  1. 1 Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
  2. 2 Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
  3. 3 Faculty of Medicine, National Yang Ming University, Taichung, Taiwan
  4. 4 Department of Medicine, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
  5. 5 Department of Medical Research, Rheumatic Diseases Research Center, China Medical University Hospital, Taichung, Taiwan
  6. 6 School of Medicine, China Medical University, Taichung, Taiwan
  1. Correspondence to Professor Der-Yuan Chen, Department of Medicine, Rheumatology and Immunology Center, China Medical University Hospital, Taichung 40447, Taiwan; dychen1957{at}gmail.com

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Tuberculosis (TB) remains a major public health issue: an estimated 10.4 million people developed TB disease and 1.4 million died from it in 2015.1 TB risk was 2.28-fold greater in patients with rheumatoid arthritis (RA) compared with controls,2 and even higher in those receiving biologic therapy.3 Guidelines have recommended that latent TB infection (LTBI) screening should be performed and prophylactic therapy be initiated if LTBI exists.4 Consequently, completion of LTBI treatment is essential for TB control in such patients.

The long therapeutic period and hepatotoxicity are barriers to completing 9-month daily isoniazid (9H) treatment,5 the standard LTBI therapy. Recently, implementing 3-month once-weekly isoniazid plus rifapentine (3HP) by directly observed therapy effectively prevented TB and increased treatment adherence.6 However, 3HP regimen has not been assessed for treating LTBI in RA.

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Footnotes

  • Handling editor Josef S Smolen

  • Contributors YMC conceived and designed the study, acquired clinical data, conducted data analysis, and drafted and revised the manuscript. TLL and HHC conceived the study, acquired clinical data, conducted data analysis and drafted the manuscript. DYC generated the original hypothesis, conceived and designed the study, acquired clinical data, conducted data analysis, and drafted and revised the manuscript.

  • Funding This study was supported by a grant from the National Science Council, Taiwan (NSC-100-2321-B-075A-001) and a grant from Taichung Veterans General Hospital, Taiwan (TCVGH-993804C).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Ethics Committee of Clinical Research, Taichung Veterans General Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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