Three Months of Weekly Rifapentine and Isoniazid Versus Four Months of Daily Rifampicin for Tuberculosis Infection: A Randomized Controlled Trial.
Vicky W L Chang, Qingbin Li, David Barnes et al.
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In 30 seconds
This multicenter, open-label randomized controlled trial compared treatment completion with weekly isoniazid plus rifapentine for 3 months (3HP) versus daily rifampicin for 4 months (4RIF) among people of any age with tuberculosis infection at seven clinics in Sydney, Australia. All doses were self-administered, and the 3HP group received weekly SMS adherence reminders. In intention-to-treat analysis, completion—defined as taking at least 90% of prescribed doses—was higher with 3HP: 84.9% versus 65.4% with 4RIF (relative risk, 1.30 [95% confidence interval, 1.22-1.38]; P < .001).
Key findings
- Treatment completion was 84.9% with weekly 3HP and 65.4% with daily 4RIF (relative risk, 1.30 [95% confidence interval, 1.22-1.38]; P < .001).
- Adverse events of any grade occurred in 24.5% of participants receiving 3HP and 20.2% receiving 4RIF.
- No treatment-related deaths were reported.
Why it matters
Completing preventive treatment is important to tuberculosis infection programs, and this direct randomized comparison found higher completion with the shorter weekly regimen when paired with SMS reminders. The similar reported safety profile provides useful comparative evidence for program planning, while the completion result should be interpreted in the context of the adherence support provided to the 3HP group.
What to keep in mind
The trial was open-label and conducted at seven clinics in Sydney. Weekly SMS adherence reminders were provided only to the 3HP group, so the comparison does not isolate regimen frequency from this additional support.