Diabetes impacts plasma concentration and bioavailability of rifampicin in TB patients: Study
Egypt: Patients with both diabetes and tuberculosis (TB) were more likely to have low plasma levels of rifampicin two hour following the administration of the TB drug, a recent study has revealed.
Findings of the study, published in the Therapies journal, found that diabetes is attributed to 37% of low plasma concentration of rifampicin n 2-h after administration but is not influenced by rifampicin's bioavailability, maximum plasma concentration, and half-life. Diabetes negative effect on plasma concentration 2 hours after administration was influenced by income level, diabetes management, type of tuberculosis, and its recurrence.
The study was conducted by Amera Sh.Metwally, Zagazig University Hospitals, Zagazig University, Zagazig, Egypt, and colleagues with the objective to assess the impact of diabetes mellitus on plasma concentration and bioavailability of rifampicin.
For this purpose, the researchers screened th online databases until September 2020 on studies reported rifampicin's plasma concentration, bioavailability among diabetic tuberculosis patients and non-diabetic tuberculosis patients. The pooled estimate was operated by a random or fixed effect model according to the presence or absence of heterogeneity. Sensitivity analysis or subgroup analysis were conducted. Calculation was done of attributed risk fraction of diabetes mellitus in the incidence of low rifampicin's plasma concentration 2-h after administration.
Based on the study, the researchers found the following:
- Seventeen studies including 3478 tuberculosis patients were included in this study.
- Diabetic tuberculosis patients had 1.59 folds incidence of low rifampicin's plasma concentration 2-h after administrations (risk ratio 1.59) and lower rifampicin's plasma concentration 2-h after administrations compared with non-diabetic tuberculosis patients.
- The attributed risk fraction of diabetes mellitus in the incidence of low rifampicin's plasma concentration 2-h after administration was 37%.
- There was no significant difference in rifampicin's maximum plasma concentration, event of low maximum plasma concentration, bioavailability and half-life between both groups.
The researchers wrote, "diabetes mellitus attributed with 37% of low rifampicin's plasma concentration 2-h after administration but not influenced rifampicin's maximum plasma concentration, bioavailability and half-life."
Reference:
El-Sheikh SMA, Metwally AS, Galal AAA. Impact of diabetes mellitus on rifampicin's plasma concentration and bioavailability in patients with tuberculosis: A systematic review and meta-analysis study. Therapie. 2022 May 21:S0040-5957(22)00101-9. doi: 10.1016/j.therap.2022.05.005. Epub ahead of print. PMID: 35717337.
