RevoFloxacin protects tuberculosis contact by meta analysis instead of RCT.

Image credit: ANNA SHVETS

The daily revoloxacin expansion course is effective in preventing household contact between people with multidrug -resistant tuberculosis (TB), and in the meta analysis of contrasting tests with adults, another meta analysis of the test with children. It was discovered in.^1-3 However, the statistically significant separation from the placebo in meta analysis did not occur in each test.

The different surveys have prompted the accompanying editorials and urged them to reinforce patients who handle patients, not the results of the lab, as “handling patients instead of P value.”⁴

The chief of meta analysis, TRINH DUONG, MSC, MSC, MSC, UNIVERSITY COLLEGE LONDON, London, UK, and colleagues are inadequate the exams and have a lower TB generation rate than expected. It is suggested.

Duon and his colleagues explain that pooling data in meta analysis has led to more accurate estimation of therapeutic effects. In addition, the Bagian Law Analysis describes that it provides evidence of therapeutic effects in each test group separately and indicates that the effects are similar among adults, and children. “

The editorial is the Emer Hoji Santor, BSEC, Mike Fralick, MD, PHD, Lunenfeld-Tanenbaum Research Institute It is pointed out that it is a scale I am doing it. And it should not always be useful as a border for binary clinical decisions.

“Hodzic-Santor and Fralick have declared that it is the simplification process to determine whether the treatment is functioning by applying only the P value or 95 % CI (trust section).

The factors they need to consider were that there was no proof of treatment to prevent multidrug -resistant tuberculosis, before this meta analysis test. Please note that.

The exam was Vietnaminoron (VQUIN) for the MDR-TB test.² Mainly adulthood cohort and tuberculosis child -resistant drug resistance therapy test³ (TB-Champ) In South Africa, we have registered which participants with microbially confirmed pulmonary rifampin resistance/MDR-TB exposure to personal exposure to individuals. Participants were included if they show evidence of potential infection MyCobacterium tuberculosis (MTB) The immunity sensation had a human immune -free virus (HIV) or was significantly malnourished.

Each participant was assigned randomly at a ratio of 1: 1 and received either a daily plasbo or revoloxaccine (for adults for 26 weeks for 26 weeks, 26 weeks at TB-CHAMP. The child received 15-20mg/kg for up to 96 weeks, 72 weeks.

“This time frame was selected based on previous studies, which is indicated by most contacts that develop tuberculosis diseases after exposure. MTB If you do so within 12 months, your concerns with subsequent re -external and external reinfections may be reduced in therapeutic effects, “said Duon and his colleague.

In both exams, it turned out that there were few participants who develop tuberculosis diseases in the Revo Frohloxacin group, but the difference from placebo was not statistically significant. However, in the meta analysis, the daily Revo Frohloxacin was associated with a 60 % decrease in the tuberculosis rate of the family contact for six months. Despite the increase in the risk of muscle skeletal adverse events.

“We need further evaluations of risk vene fit balance, ninja, and cost-effectiveness of MDR-TB preventive treatment in various groups,” he recommends.

reference

1. Duong T, Brigden J, Schaaf SH, and Metal analysis of revoloxacin for other multilateral tuberculosis.NEJM EVID 2025; 2: 10.1056/EvidoA2400190.
2. Foxgj, nguyen vn, nguyen CB, et al. Revoofloxacin to prevent multidrug -resistant tuberculosis in Vietnam. N English J with 2024; DOI: 10.1056/NEJMOA2314325.
3. Hesselingac, Purchase SE, Martinson Na, et al. Revo basin prevention treatment for children exposed to MDR-TB. N English J with 2024; DOI: 1056/NEJMOA2314318.
4. Hodzic-Santor E, the treatment of patients, not Fralick M. P value. editorial. NEJM EVID 2025; 2:1056/Evide2400405.