Higher adverse drug reactions but better completion rate of twelve-dose weekly rifapentine plus isoniazid comparing with nine-month daily isoniazid for latent tuberculosis infection among patients under maintenance dialysis

<b>Background:</b> Although patients with end-stage renal disease (ESRD) receiving dialysis are considered a high risk group for tuberculosis, the optimal treatment regimen for latent tuberculosis infection (LTBI) had not been studied yet. <b>Aim:</b> To compare the two regimens – twelve-dose weekly rifapentine plus isoniazid (3HP) and nine-month daily isoniazid (9H) for LTBI among patients under maintenance dialysis, with emphasis on completion rate and adverse drug reactions (ADR). <b>Method:</b> Since September 2014, we prospectively followed ESRD patients screened and treated for LTBI in three medical centers and one regional hospital in north Taiwan. Patients received 3HP or 9H for LTBI treatment if clinically suitable. Patients on 3HP were obliged to join directly observed preventive therapy program (DOPT), while those on 9H received DOPT based on availability. Laboratory results, ADR, reasons for discontinuation were recorded. <b>Results:</b> 88 ESRD patients and 91 treatment courses (9H n=41, 3HP n=50) were recorded. The completion rate was 50% (16/32) for 9H and 81.3% (39/48) for 3HP (p=0.003). The leading cause of incomplete treatment was patient refusal for 9H (50%) and ADR for 3HP (55.6%). Malaise was the most frequently reported ADR in both regimens. Higher rate of ≥grade 2 ADRs were reported among 3HP regimen (45.8% vs 15.8%, p=0.003). AST (aspartate aminotransaminase) elevation &lt;2x upper limit were observed in both regimens. <b>Conclusion:</b> Despite higher rate of ADR using 3HP regimen, ESRD patients on maintenance dialysis could had higher rate of completion as compared with 9H.