RT Journal Article
SR Electronic
T1 Current Treatment Options for Latent Tuberculosis Infection
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 71
OP 77
DO 10.3899/jrheum.140105
VO 91
A1 Marialuisa Bocchino
A1 Alessandro Matarese
A1 Alessandro Sanduzzi
YR 2014
UL http://www.jrheum.org/content/91/71.abstract
AB Treatment of latent tuberculosis infection (LTBI) is a key component in TB control strategies worldwide. However, as people with LTBI are neither symptomatic nor contagious, any screening decision should be weighed carefully against the potential benefit of preventing active disease in those who are known to be at higher risk and are willing to accept therapy for LTBI. This means that a targeted approach is desirable to maximize cost effectiveness and to guarantee patient adherence. We focus on LTBI treatment strategies in patient populations at increased risk of developing active TB, including candidates for treatment with tumor necrosis factor-α blockers. In the last 40 years, isoniazid (INH) has represented the keystone of LTBI therapy across the world. Although INH remains the first therapeutic option, alternative treatments that are effective and associated with increased adherence and economic savings are available. Current recommendations, toxicity, compliance, and cost issues are discussed in detail in this review. A balanced relationship between the patient and healthcare provider could increase adherence, while cost-saving treatment strategies with higher effectiveness, fewer side effects, and of shorter duration should be offered as preferred.