title: Treatment of latent tuberculosis infection: a network meta-analysis.
abstract: BACKGROUND
  Effective treatment of latent tuberculosis infection (LTBI) is an important component of TB elimination programs. Promising new regimens that may be more effective are being introduced. Because few regimens can be directly compared, network meta-analyses, which allow indirect comparisons to be made, strengthen conclusions.
  
  
  OBJECTIVE
  To determine the most efficacious regimen for preventing active TB with the lowest likelihood of adverse events to inform LTBI treatment policies.
  
  
  METHODS
  PubMed, EMBASE, and Web of Science up to 29 January 2014; clinical trial registries; and conference abstracts.
  
  
  METHODS
  Randomized, controlled trials that evaluated LTBI treatment in humans and recorded at least 1 of 2 prespecified end points (preventing active TB or hepatotoxicity), without language or date restrictions.
  
  
  METHODS
  Data from eligible studies were independently extracted by 2 investigators according to a standard protocol.
  
  
  RESULTS
  Of the 1516 articles identified, 53 studies met the inclusion criteria. Data on 15 regimens were available; of 105 possible comparisons, 42 (40%) were compared directly. Compared with placebo, isoniazid for 6 months (odds ratio [OR], 0.64 [95% credible interval {CrI}, 0.48 to 0.83]) or 12 months or longer (OR, 0.52 [CrI, 0.41 to 0.66]), rifampicin for 3 to 4 months (OR, 0.41 [CrI, 0.18 to 0.86]), and rifampicin-isoniazid regimens for 3 to 4 months (OR, 0.52 [CrI, 0.34 to 0.79]) were efficacious within the network.
  
  
  CONCLUSIONS
  The risk of bias was unclear for many studies across various domains. Evidence was sparse for some comparisons, particularly hepatotoxicity.
  
  
  CONCLUSIONS
  Comparison of different LTBI treatment regimens showed that various therapies containing rifamycins for 3 months or more were efficacious at preventing active TB, potentially more so than isoniazid alone. Regimens containing rifamycins may be effective alternatives to isoniazid monotherapy.
  
  
  BACKGROUND
  None.
authors.forename: Helen R
authors.initials: HR
authors.lastname: Stagg
authors.forename: Dominik
authors.initials: D
authors.lastname: Zenner
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Harris
authors.forename: Laura
authors.initials: L
authors.lastname: Muñoz
authors.forename: Marc C
authors.initials: MC
authors.lastname: Lipman
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abubakar
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects / Q000627:therapeutic use; D055985:Latent Tuberculosis / Q000188:drug therapy*; D011718:Pyrazinamide / Q000009:adverse effects / Q000627:therapeutic use; D012293:Rifampin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin; C018421:rifapentine