ADVERSE DRUG REACTIONS IN TUBERCULOSIS AND MANAGEMENT

Background: Around 10 million people worldwide contract tuberculosis (TB) every year. According to the World Health Organization (WHO), approximately one-quarter of the world’s population is latently infected with Mycobacterium tuberculosis. Its treatment is extremely long and patients may experience a variety of adverse reactions. Objectives: The aim of this study was to assess the different adverse drug reactions (ADR’s) in patients treated with first-line anti-tubercular drugs. Methods: This retrospective study included 45 cases of TB followed in the Rheumatology department of Farhat Hached hospital in Sousse, Tunisia, over a period of 22 years (1998-2020). Results: The mean age was 52.2 ± 17.72 years [14-95 years]. These were 19 men (42.2%) and 26 women (57.8%).The different locations of tuberculosis were as follows: pulmonary for 5 patients (11.1%), spinal for 26 patients (57.8%), articular for one patient (2.2%), urinary for two (4.4%), and multifocal for 8 patients (17.8%). An anti-tuberculosis treatment (based on quadrytherapy: Rifadine(R), Isoniazide(I), Pyrazinamide (Z) and Ethambutol (E)during 2 months, followed by biotherapy based on (R)and (I) was prescribed for an average duration of 10.85 months [6-24 months]. ADR’s were observed in 53.33% of patients. Abdominal pain and nausea were detected in 5 cases (11.1%). Hepatic cytolyse was noticed in 8 cases (17.8%) under (R). Cholestatic hepatitis occurred in 9 cases (20%) under (R). Asymptomatic Hyperuricemia was detected in 15 cases (33.3%) with (E). Two cases of toxiderma were detected: the first under (E) and the second under (E) + (Z). Ethambutol was responsible for a case of DRESS syndrome and a case of drug-induced hepatitis. One case of hemolytic anemia had occurred under (R). A sensorineural hearing loss was noted under streptomycin in one case. No fatal side effects were observed. These ADR’s were reversible in all cases. Conclusion: The treatment of TB can cause a variety of ADRs’. Early recognition by active surveillance and appropriate management of these ADRs’ might improve adherence and treatment success. REFERENCES: [1]Prasad, R., Singh, A., & Gupta, N. Adverse drug reactions in tuberculosis and management. Indian Journal of Tuberculosis, 66(4), 520–532 (2019). Disclosure of Interests: None declared Citation: Ann Rheum Dis, volume 80, supplement 1, year 2021, page 923Session: Spine, mechanical musculoskeletal problems, local soft tissue disorders (POSTERS only)