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Gender differences in tuberculosis treatment outcomes: a post hoc analysis of the REMoxTB study.


ABSTRACT:

Background

In the REMoxTB study of 4-month treatment-shortening regimens containing moxifloxacin compared to the standard 6-month regimen for tuberculosis, the proportion of unfavourable outcomes for women was similar in all study arms, but men had more frequent unfavourable outcomes (bacteriologically or clinically defined failure or relapse within 18 months after randomisation) on the shortened moxifloxacin-containing regimens. The reason for this gender disparity in treatment outcome is poorly understood.

Methods

The gender differences in baseline variables were calculated, as was time to smear and culture conversion and Kaplan-Meier plots were constructed. In post hoc exploratory analyses, multivariable logistic regression modelling and an observed case analysis were used to explore factors associated with both gender and unfavourable treatment outcome.

Results

The per-protocol population included 472/1548 (30%) women. Women were younger and had lower rates of cavitation, smoking and weight (all p?ConclusionsGender differences in TB treatment responses for the shorter regimens in the REMoxTB study may be explained by poor outcomes in men with cavitation on the moxifloxacin-containing regimens. We observed that women with cavities, or without, on the 4-month moxifloxacin regimens had similar outcomes to all patients on the standard 6-month treatment. The biological reasons for this difference are poorly understood and require further exploration.

SUBMITTER: Murphy ME 

PROVIDER: S-EPMC6192317 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Gender differences in tuberculosis treatment outcomes: a post hoc analysis of the REMoxTB study.

Murphy M E ME   Wills G H GH   Murthy S S   Louw C C   Bateson A L C ALC   Hunt R D RD   McHugh T D TD   Nunn A J AJ   Meredith S K SK   Mendel C M CM   Spigelman M M   Crook A M AM   Gillespie S H SH  

BMC medicine 20181017 1


<h4>Background</h4>In the REMoxTB study of 4-month treatment-shortening regimens containing moxifloxacin compared to the standard 6-month regimen for tuberculosis, the proportion of unfavourable outcomes for women was similar in all study arms, but men had more frequent unfavourable outcomes (bacteriologically or clinically defined failure or relapse within 18 months after randomisation) on the shortened moxifloxacin-containing regimens. The reason for this gender disparity in treatment outcome  ...[more]

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