A randomised controlled trial of N-acetylcysteine in the management of anti-tuberculosis drug-induced liver injury
| dc.contributor.advisor | Cohen, Karen | |
| dc.contributor.advisor | Maartens Gary | |
| dc.contributor.author | Moosa, Muhammed | |
| dc.date.accessioned | 2023-09-11T13:17:11Z | |
| dc.date.available | 2023-09-11T13:17:11Z | |
| dc.date.issued | 2023 | |
| dc.date.updated | 2023-09-11T13:07:43Z | |
| dc.description.abstract | Background: Liver injury is the most common severe adverse effect of first-line anti-tuberculosis therapy (ATT). Nacetylcysteine (NAC) has efficacy in patients with paracetamol toxicity, and may be of benefit in liver injury due to other causes, such as ATT-induced liver injury (AT-DILI). Rechallenge of first line ATT after liver injury is usually attempted and may result in recurrence of liver injury. Alanine transaminase (ALT) is the biomarker currently used in AT-DILI diagnosis. MicroRNA-122 (miR-122) is a sensitive biomarker for liver injury due to paracetamol, but data on utility as a biomarker for ATDILI are limited. Methods: We conducted a randomized double-blind placebo-controlled trial of intravenous NAC in adult hospitalized participants with AT-DILI. Primary endpoint was time to ALT < 100 U/L; secondary endpoints included length of hospital stay and 8-week mortality. We described outcomes of ATT rechallenge following AT-DILI. We quantified miR-122 and ALT concentrations before and after infusion of NAC/placebo, and explored the effect of NAC on miR-122. Results We enrolled 102 participants with AT-DILI, 53 randomized to NAC and 49 to placebo. Mean age was 38 (SDĀ±10) years, 58 (57%) were female and 89 (87%) were HIV positive. Median time to ALT | |
| dc.identifier.apacitation | Moosa, M. (2023). <i>A randomised controlled trial of N-acetylcysteine in the management of anti-tuberculosis drug-induced liver injury</i>. (). ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/38515 | en_ZA |
| dc.identifier.chicagocitation | Moosa, Muhammed. <i>"A randomised controlled trial of N-acetylcysteine in the management of anti-tuberculosis drug-induced liver injury."</i> ., ,Faculty of Health Sciences ,Department of Medicine, 2023. http://hdl.handle.net/11427/38515 | en_ZA |
| dc.identifier.citation | Moosa, M. 2023. A randomised controlled trial of N-acetylcysteine in the management of anti-tuberculosis drug-induced liver injury. . ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/38515 | en_ZA |
| dc.identifier.ris | TY - Doctoral Thesis AU - Moosa, Muhammed AB - Background: Liver injury is the most common severe adverse effect of first-line anti-tuberculosis therapy (ATT). Nacetylcysteine (NAC) has efficacy in patients with paracetamol toxicity, and may be of benefit in liver injury due to other causes, such as ATT-induced liver injury (AT-DILI). Rechallenge of first line ATT after liver injury is usually attempted and may result in recurrence of liver injury. Alanine transaminase (ALT) is the biomarker currently used in AT-DILI diagnosis. MicroRNA-122 (miR-122) is a sensitive biomarker for liver injury due to paracetamol, but data on utility as a biomarker for ATDILI are limited. Methods: We conducted a randomized double-blind placebo-controlled trial of intravenous NAC in adult hospitalized participants with AT-DILI. Primary endpoint was time to ALT < 100 U/L; secondary endpoints included length of hospital stay and 8-week mortality. We described outcomes of ATT rechallenge following AT-DILI. We quantified miR-122 and ALT concentrations before and after infusion of NAC/placebo, and explored the effect of NAC on miR-122. Results We enrolled 102 participants with AT-DILI, 53 randomized to NAC and 49 to placebo. Mean age was 38 (SDĀ±10) years, 58 (57%) were female and 89 (87%) were HIV positive. Median time to ALT DA - 2023 DB - OpenUCT DP - University of Cape Town KW - Liver injury KW - Nacetylcysteine (NAC) LK - https://open.uct.ac.za PY - 2023 T1 - A randomised controlled trial of N-acetylcysteine in the management of anti-tuberculosis drug-induced liver injury TI - A randomised controlled trial of N-acetylcysteine in the management of anti-tuberculosis drug-induced liver injury UR - http://hdl.handle.net/11427/38515 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/38515 | |
| dc.identifier.vancouvercitation | Moosa M. A randomised controlled trial of N-acetylcysteine in the management of anti-tuberculosis drug-induced liver injury. []. ,Faculty of Health Sciences ,Department of Medicine, 2023 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/38515 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Department of Medicine | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | Liver injury | |
| dc.subject | Nacetylcysteine (NAC) | |
| dc.title | A randomised controlled trial of N-acetylcysteine in the management of anti-tuberculosis drug-induced liver injury | |
| dc.type | Doctoral Thesis | |
| dc.type.qualificationlevel | Doctoral | |
| dc.type.qualificationlevel | PhD |