Diabetes is Associated with Severe Adverse Events in Multidrug-Resistant Tuberculosis

Marcela Muñoz-Torrico, José Caminero-Luna, Giovanni Battista Migliori, Lia D'Ambrosio, José Luis Carrillo-Alduenda, Héctor Villareal-Velarde, Alfredo Torres-Cruz, Héctor Flores-Vergara, Dina Martínez-Mendoza, Cecilia García-Sancho, Rosella Centis, Miguel Ángel Salazar-Lezama, Rogelio Pérez-Padilla

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Diabetes mellitus (DM), a very common disease in Mexico, is a well-known risk factor for tuberculosis (TB). However, it is not known by which extent DM predisposes to adverse events (AE) to anti-TB drugs and/or to worse outcomes in patients with multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB). The main objective of this study was to describe the outcomes of TB treatment, the impact of DM and the prevalence of AE in a cohort of patients with MDR-/XDR pulmonary TB treated at the national TB referral centre in Mexico City.

RESULTS: Ninety patients were enrolled between 2010 and 2015: 73 with MDR-TB (81.1%), 11 with pre-XDR-TB (12.2%) and 6 (6.7%) with XDR-TB, including 49 (54.4%) with DM, and 3 with Human Immunodeficiency Virus (HIV) co-infection (3.3%). In 98% of patients, diagnosis was made by culture and drug susceptibility testing, while in a single case the diagnosis was made by a molecular test. The presence of DM was associated with an increased risk of serious drug-related AEs, such as nephrotoxicity (Odds Ratio [OR]=6.5; 95% Confidence Interval [95% CI]: 1.9-21.8) and hypothyroidism (OR=8.8; 95% CI: 1.8-54.2), but not for a worse outcome.

CONCLUSIONS: Our data suggest that DM does not impact second-line TB treatment outcomes, but patients with DM have a higher risk of developing serious AEs to drug-resistant TB treatment, such as nephrotoxicity and hypothyroidism.

Original languageEnglish
Pages (from-to)245-250
Number of pages6
JournalArchivos de Bronconeumologia
Volume53
Issue number5
DOIs
Publication statusPublished - May 2017

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Multidrug-Resistant Tuberculosis
Tuberculosis
Diabetes Mellitus
Hypothyroidism
Mexico
Extensively Drug-Resistant Tuberculosis
Odds Ratio
Pharmaceutical Preparations
Confidence Intervals
Virus Diseases
Coinfection
Pulmonary Tuberculosis
Referral and Consultation
HIV

Keywords

  • Journal Article

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Muñoz-Torrico, M., Caminero-Luna, J., Migliori, G. B., D'Ambrosio, L., Carrillo-Alduenda, J. L., Villareal-Velarde, H., ... Pérez-Padilla, R. (2017). Diabetes is Associated with Severe Adverse Events in Multidrug-Resistant Tuberculosis. Archivos de Bronconeumologia, 53(5), 245-250. https://doi.org/10.1016/j.arbres.2016.10.021

Diabetes is Associated with Severe Adverse Events in Multidrug-Resistant Tuberculosis. / Muñoz-Torrico, Marcela; Caminero-Luna, José; Migliori, Giovanni Battista; D'Ambrosio, Lia; Carrillo-Alduenda, José Luis; Villareal-Velarde, Héctor; Torres-Cruz, Alfredo; Flores-Vergara, Héctor; Martínez-Mendoza, Dina; García-Sancho, Cecilia; Centis, Rosella; Salazar-Lezama, Miguel Ángel; Pérez-Padilla, Rogelio.

In: Archivos de Bronconeumologia, Vol. 53, No. 5, 05.2017, p. 245-250.

Research output: Contribution to journalArticle

Muñoz-Torrico, M, Caminero-Luna, J, Migliori, GB, D'Ambrosio, L, Carrillo-Alduenda, JL, Villareal-Velarde, H, Torres-Cruz, A, Flores-Vergara, H, Martínez-Mendoza, D, García-Sancho, C, Centis, R, Salazar-Lezama, MÁ & Pérez-Padilla, R 2017, 'Diabetes is Associated with Severe Adverse Events in Multidrug-Resistant Tuberculosis', Archivos de Bronconeumologia, vol. 53, no. 5, pp. 245-250. https://doi.org/10.1016/j.arbres.2016.10.021
Muñoz-Torrico M, Caminero-Luna J, Migliori GB, D'Ambrosio L, Carrillo-Alduenda JL, Villareal-Velarde H et al. Diabetes is Associated with Severe Adverse Events in Multidrug-Resistant Tuberculosis. Archivos de Bronconeumologia. 2017 May;53(5):245-250. https://doi.org/10.1016/j.arbres.2016.10.021
Muñoz-Torrico, Marcela ; Caminero-Luna, José ; Migliori, Giovanni Battista ; D'Ambrosio, Lia ; Carrillo-Alduenda, José Luis ; Villareal-Velarde, Héctor ; Torres-Cruz, Alfredo ; Flores-Vergara, Héctor ; Martínez-Mendoza, Dina ; García-Sancho, Cecilia ; Centis, Rosella ; Salazar-Lezama, Miguel Ángel ; Pérez-Padilla, Rogelio. / Diabetes is Associated with Severe Adverse Events in Multidrug-Resistant Tuberculosis. In: Archivos de Bronconeumologia. 2017 ; Vol. 53, No. 5. pp. 245-250.
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T1 - Diabetes is Associated with Severe Adverse Events in Multidrug-Resistant Tuberculosis

AU - Muñoz-Torrico, Marcela

AU - Caminero-Luna, José

AU - Migliori, Giovanni Battista

AU - D'Ambrosio, Lia

AU - Carrillo-Alduenda, José Luis

AU - Villareal-Velarde, Héctor

AU - Torres-Cruz, Alfredo

AU - Flores-Vergara, Héctor

AU - Martínez-Mendoza, Dina

AU - García-Sancho, Cecilia

AU - Centis, Rosella

AU - Salazar-Lezama, Miguel Ángel

AU - Pérez-Padilla, Rogelio

N1 - Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

PY - 2017/5

Y1 - 2017/5

N2 - INTRODUCTION: Diabetes mellitus (DM), a very common disease in Mexico, is a well-known risk factor for tuberculosis (TB). However, it is not known by which extent DM predisposes to adverse events (AE) to anti-TB drugs and/or to worse outcomes in patients with multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB). The main objective of this study was to describe the outcomes of TB treatment, the impact of DM and the prevalence of AE in a cohort of patients with MDR-/XDR pulmonary TB treated at the national TB referral centre in Mexico City.RESULTS: Ninety patients were enrolled between 2010 and 2015: 73 with MDR-TB (81.1%), 11 with pre-XDR-TB (12.2%) and 6 (6.7%) with XDR-TB, including 49 (54.4%) with DM, and 3 with Human Immunodeficiency Virus (HIV) co-infection (3.3%). In 98% of patients, diagnosis was made by culture and drug susceptibility testing, while in a single case the diagnosis was made by a molecular test. The presence of DM was associated with an increased risk of serious drug-related AEs, such as nephrotoxicity (Odds Ratio [OR]=6.5; 95% Confidence Interval [95% CI]: 1.9-21.8) and hypothyroidism (OR=8.8; 95% CI: 1.8-54.2), but not for a worse outcome.CONCLUSIONS: Our data suggest that DM does not impact second-line TB treatment outcomes, but patients with DM have a higher risk of developing serious AEs to drug-resistant TB treatment, such as nephrotoxicity and hypothyroidism.

AB - INTRODUCTION: Diabetes mellitus (DM), a very common disease in Mexico, is a well-known risk factor for tuberculosis (TB). However, it is not known by which extent DM predisposes to adverse events (AE) to anti-TB drugs and/or to worse outcomes in patients with multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB). The main objective of this study was to describe the outcomes of TB treatment, the impact of DM and the prevalence of AE in a cohort of patients with MDR-/XDR pulmonary TB treated at the national TB referral centre in Mexico City.RESULTS: Ninety patients were enrolled between 2010 and 2015: 73 with MDR-TB (81.1%), 11 with pre-XDR-TB (12.2%) and 6 (6.7%) with XDR-TB, including 49 (54.4%) with DM, and 3 with Human Immunodeficiency Virus (HIV) co-infection (3.3%). In 98% of patients, diagnosis was made by culture and drug susceptibility testing, while in a single case the diagnosis was made by a molecular test. The presence of DM was associated with an increased risk of serious drug-related AEs, such as nephrotoxicity (Odds Ratio [OR]=6.5; 95% Confidence Interval [95% CI]: 1.9-21.8) and hypothyroidism (OR=8.8; 95% CI: 1.8-54.2), but not for a worse outcome.CONCLUSIONS: Our data suggest that DM does not impact second-line TB treatment outcomes, but patients with DM have a higher risk of developing serious AEs to drug-resistant TB treatment, such as nephrotoxicity and hypothyroidism.

KW - Journal Article

U2 - 10.1016/j.arbres.2016.10.021

DO - 10.1016/j.arbres.2016.10.021

M3 - Article

C2 - 28089216

VL - 53

SP - 245

EP - 250

JO - Archivos de Bronconeumologia

JF - Archivos de Bronconeumologia

SN - 0300-2896

IS - 5

ER -