title: The challenges of pharmacokinetic variability of first-line anti-TB drugs.
abstract: Inter-individual variations in the pharmacokinetics (PK) of anti-TB drugs are known to occur, which could have important therapeutic implications in patient management. Areas covered: We compiled factors responsible for PK variability of anti-TB drugs reported from different settings that would give a better understanding about the challenges of PK variability of anti-TB medications. We searched PubMed data base and Google scholar from 1976 to the present using the key words 'Pharmacokinetics', 'pharmacokinetic variability', 'first-line anti-TB therapy', 'Rifampicin', 'Isoniazid', 'Ethambutol', 'Pyrazinamide', 'food', 'nutritional status', 'HIV', 'diabetes', 'genetic polymorphisms' and 'pharmacokinetic interactions'. We also included abstracts from scientific meetings and review articles. Expert commentary: A variety of host and genetic factors can cause inter-individual variations in the PK of anti-TB drugs. PK studies conducted in various settings have adopted different designs, PK sampling time points, drug estimation methodologies. Hence comparison and interpretation of these results should be done with caution More phamacogenomic studies in different patient populations are needed for further understanding.
authors.affiliation: a Department of Clinical Research , National Institute for Research in Tuberculosis , Chennai , Tamil Nadu , India.
authors.forename: Bella
authors.initials: B
authors.lastname: Devaleenal Daniel
authors.affiliation: a Department of Clinical Research , National Institute for Research in Tuberculosis , Chennai , Tamil Nadu , India.
authors.forename: Geetha
authors.initials: G
authors.lastname: Ramachandran
authors.affiliation: b Secretary Department of Health Research & Director General , Indian Council of Medical Research , New Delhi , India.
authors.forename: Soumya
authors.initials: S
authors.lastname: Swaminathan
mesh_terms: D000818:Animals; D000995:Antitubercular Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006801:Humans; D010597:Pharmacogenetics; D012107:Research Design; D013048:Specimen Handling; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy* / Q000235:genetics
chemical_list: D000995:Antitubercular Agents
keywords: First-line anti TB drugs; interactions; pharmacokinetics; tuberculosis; variability