Are Fixed-Dose Combinations or Single-Drug Formulations Better for Tuberculosis Treatment?

Researchers recently created a Cochrane Systematic Review that evaluates the efficacy, safety, and adherence to fixed-dose combinations (FDC) of drugs and single-drug formulations for the treatment of newly diagnosed tuberculosis (TB).

The treatment for pulmonary TB is a regimen that requires 2 months of isoniazid, rifampicin, pyrazinamide, and ethambutol, and then 4 months of isoniazid and rifampicin in FDCs (combined into 1 tablet) or single-drug formulations (separate).

Nonadherence to tuberculosis drugs are a problem due to how long and complex the regimen is. Nonadherence can fail to cure patients and creates a chronically contagious case, which may become drug-resistant, according to the review.

The researchers evaluated the FDC regimen on safety, acceptability by the recipient, and its ability to treat pulmonary TB compared with single-drug formulations.

Data from 13 previous trials that included 5824 patients aged 15 years and older with newly-diagnosed pulmonary TB was included. Researchers found little to no difference between the treatments regarding treatment failure, but relapse may be more frequent with FDC treatment, according to the review.

There was a similar mortality rate between the 2 regimens. The researchers noted little to no evidence in serious side effects or causes that led to discontinuation between the regimens. FDCs have similar efficacy to single-drug formulations for pulmonary TB treatment, the researchers concluded.