Safety of pyrazinamide in elderly patients with tuberculosis in Japan: A nationwide cohort study

• DOI: 10.1111/resp.14753
• Publication Date: 2024-05-22T00:47:45Z
• Authors: Jumpei Taniguchi; Taisuke Jo; Shotaro Aso; Hiroki Matsui; Kiyohide Fushimi; Hideo Yasunaga
• Keywords: Pyrazinamide

Abstract Background and Objective Pyrazinamide (PZA) is the standard first‐line treatment for tuberculosis (TB); however, its safety in elderly patients has not been thoroughly investigated. Methods This retrospective study used data from Japanese Diagnosis Procedure Combination inpatient database. We identified who were admitted TB between July 2010 March 2022. Patients categorized into HRE (isoniazid, rifampicin ethambutol) HREZ rifampicin, ethambutol PZA) groups. Primary outcomes included in‐hospital mortality overall adverse events (characterized by a composite of hepatotoxicity, gout attack, allergic reactions gastrointestinal intolerance). Secondary length hospital stay, 90‐day readmission use drugs related to primary outcome events. Data analysed using propensity score matching; we also conducted subgroup analysis those aged ≥75 years. Results Among 19,930 eligible patients, 8924 received 11,006 HREZ. Propensity matching created 3578 matched pairs with mean age approximately 80 Compared group, group demonstrated higher proportion (3.1% vs. 4.7%; p < 0.001), (1.4% 2.5%; 0.001) antihistamine (21.9% 27.6%; 0.001). No significant differences observed regarding mortality, hepatotoxicity or stay Subgroup years showed consistent results. Conclusion Medical practitioners may consider adding PZA an initial regimen even TB.