利福布丁较利福喷丁治疗耐多药肺结核的系统评价

Rifabutin Versus Rifapentine for the Treatment of Multi-drug Resistant Pulmonary Tuberculosis:a Systematic Review

目的评价利福布丁较利福喷丁治疗耐多药肺结核的有效性和安全性。方法计算机检索Medline、the Cochrane Cen-tral Register of Controlled Trials(CENTRAL)、CBM、CNKI、万方学位论文和会议数据库,Clinical trial.gov。检索日期截止至2008年10月。纳入利福布丁较利福喷丁治疗耐多药肺结核的随机对照试验。结果共纳入1个随机对照试验,完成治疗分析的和意向性治疗分析均表明在不同治疗阶段,利福布丁和利福喷汀两组病人痰菌阴转率、病灶显效率、病灶有效率比较,差异均无统计意义(p>0.05)。利福布丁和利福喷汀两组病人满疗程时空洞闭合率、不良事件发生率、肝损害发生率及严重不良事件发生率比较,差异也无统计学意义(p>0.05)。结论一个试验提示,利福布丁与利福喷丁治疗耐多药肺结核的疗效可能相似。需进一步开展随机、双盲、对照试验来确认两药对耐多药肺结核的相对效果。

Objective To assess the efficacy and safety of rifabutin versus rifapentine for the treatment of multi-drug resistant pulmonary tuberculosis. Mothods Published literature were searched in Medline, the Coehrane Central Register of Controlled Trials, CBM, CNKI, and unpublished literature searched in Wanfang Database and Clinical Trials. gov from establishment to Oct, 2008. We includ- ed randomized controlled trials （RCTs） that compared rifabutin with rifapentine for the treatment of muhi-drug resistant pulmonary tuberculosis. Intention-to-treat and per-protocol analyses were carried out respectively. Results Only one RCT was identified. Intention- to-treat and per-protocol analyses both showed that there were no significant differences between the rifabutin and the rifapentine groups in sputum negative conversion rates, radiographically remarkable improvement rates and improvement rates at different time （p 〉0.05）. No statistically significant differences were found in cavity closing rates at the end of treatment, severe adverse effects, and hepatotoxieity between the two groups, either. Condusions The current evidence available is insufficient to assess the efficacy and safety of rifabutin versus rifapentine for the treatment of muhi-drug resistant pulmonary tuberculosis. Further double-blinded, randomized controlled trials were urgently needed.