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Ajouter le résultat dans votre panier Affiner la rechercheAn informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST) / R. Cambell (10/05/2008)
Titre : An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST) : a cluster randomised trial Type de document : texte imprimé Auteurs : R. Cambell, Auteur ; F. Starkey, Auteur ; J. Holliday, Auteur Editeur : Lancet Année de publication : 10/05/2008 Collection : The Lancet num. 371 (9624) Importance : p.1595-1602 Note générale : deux exemplaires Langues : Anglais (eng) Catégories : [NICO] étude
[NICO] étude:recherche:recherche clinique:essai contrôlé randomisé
[NICO] législation:milieu réglementé:milieu scolaire:enseignement secondaire
[NICO] prévention
[NICO] sevrage tabagique:aide au sevrageIndex. décimale : TA 5.3.1 Programmes scolaire de prévention Résumé : Dans de nombreux pays, les écoles s'embarquent dans des programmesde prévention du tabagisme, mais les revues systématiques ont montré une preuve composite de leur efficacité. La plupart des approches menées par les pairs a été mis en place dans les classes, et les évaluations rigoureuses sont rares. L'étude présentée dans ce document montre l'efficacité d'une intervention menée par les pairs qui avait pour but de prévenir la consommation de tabagisme dans les écoles secondaires. En ligne : https://www.sciencedirect.com/science/article/pii/S0140673608606923 Format de la ressource électronique : HTML, PDF Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=2770 Exemplaires (1)
Code-barres Cote Support Localisation Section Disponibilité TA 002009 TA 5.3.1 CAM I Article/Périodique Bibliothèque FARES Tabac Consultation sur place
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Titre : Assessment of Swedish snus for tobacco harm reduction : an epidemiological modelling study Type de document : texte imprimé Auteurs : Coral Gartner, Auteur Editeur : Lancet Année de publication : 2007 Collection : The Lancet Langues : Français (fre) Catégories : [DIVERS] géographie:Europe:Europe du Nord:Suède
[NICO] étude:épidémiologie
[NICO] prévention:évaluation:évaluation du tabagisme:test médical
[NICO] prévention:stratégie:réduction du risque
[NICO] produit:produit à usage oral:snusIndex. décimale : TA 1.2 Tabac non fumé Résumé : Le snus Suédois est un produit de tabac sans fumée qui a été suggéré comme produit de réduction des risques tabagiques. Notre but était d'évaluer le potentiel des effets du snus sur la santé de la population. Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=2771 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders / Mathilde Argote (2023)
Titre : Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders : an individual participant data meta-analysis on 3053 individuals Type de document : document électronique Auteurs : Mathilde Argote, Auteur ; Guillaume Sescousse, Auteur ; Jérôme Brunelin, Auteur Editeur : Lancet Année de publication : 2023 Collection : The Lancet num. 64 Importance : 13 p. Présentation : graph.,tab. Langues : Anglais (eng) Catégories : [NICO] tabagisme:pathologie:pathologie neurologique:schizophrénie
[NICO] tabagisme:risque:facteur associé:drogue:cannabisMots-clés : revue de la littérature Index. décimale : TA 1.1.5 Cannabis Résumé : Background
The association between cannabis use and positive symptoms in schizophrenia spectrum disorders is well documented, especially via meta-analyses. Yet, findings are inconsistent regarding negative symptoms, while other dimensions such as disorganization, depression, and excitement, have not been investigated. In addition, meta-analyses use aggregated data discarding important confounding variables which is a source of bias.
Methods
PubMed, ScienceDirect and PsycINFO were used to search for publications from inception to September 27, 2022. We contacted the authors of relevant studies to extract raw datasets and perform an Individual Participant Data meta-analysis (IPDMA). Inclusion criteria were: psychopathology of individuals with schizophrenia spectrum disorders assessed by the Positive and Negative Syndrome Scale (PANSS); cannabis-users had to either have a diagnosis of cannabis use disorder or use cannabis at least twice a week. The main outcomes were the PANSS subscores extracted via the 3-factor (positive, negative and general) and 5-factor (positive, negative, disorganization, depression, excitement) structures. Preregistration is accessible via Prospero: ID CRD42022329172.
Findings
Among the 1149 identified studies, 65 were eligible and 21 datasets were shared, totaling 3677 IPD and 3053 complete cases. The adjusted multivariate analysis revealed that relative to non-use, cannabis use was associated with higher severity of positive dimension (3-factor: Adjusted Mean Difference, aMD = 0.34, 95% Confidence Interval, CI = [0.03; 0.66]; 5-factor: aMD = 0.38, 95% CI = [0.08; 0.63]), lower severity of negative dimension (3-factor: aMD = −0.49, 95% CI [−0.90; −0.09]; 5-factor: aMD = −0.50, 95% CI = [−0.91; −0.08]), higher severity of excitement dimension (aMD = 0.16, 95% CI = [0.03; 0.28]). No association was found between cannabis use and disorganization (aMD = −0.13, 95% CI = [−0.42; 0.17]) or depression (aMD = −0.14, 95% CI = [−0.34; 0.06]).
Interpretation No causal relationship can be inferred from the current results. The findings could be in favor of both a detrimental and beneficial effect of cannabis on positive and negative symptoms, respectively. Longitudinal designs are needed to understand the role of cannabis is this association. The reported effect sizes are small and CIs are wide, the interpretation of findings should be taken with caution.
Funding
This research did not receive any specific grant or funding. Primary financial support for authors was provided by Le Vinatier Psychiatric Hospital.En ligne : https://doi.org/10.1016/j.eclinm.2023.102199 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10275 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Association between spending on social protection and tuberculosis burden : a global analysis Type de document : document électronique Auteurs : Andrew Siroka, Auteur ; Ninez A. Ponce, Auteur ; Knut Lönnroth, Auteur Editeur : Lancet Année de publication : 2015 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. 16(4) Importance : p.473-479 Langues : Anglais (eng) Catégories : [TUBER] aspect socio-économique
[TUBER] surveillanceIndex. décimale : TU 3. Stratégies et programmes de prévention et de contrôle Résumé : The End TB Strategy places great emphasis on increasing social protection and poverty alleviation programmes. However, the role of social protection on controlling tuberculosis has not been examined fully. We analysed the association between social protection spending and tuberculosis prevalence, incidence, and mortality globally. En ligne : https://doi.org/10.1016/S1473-3099(15)00401-6 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10028 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : C-Tb: a latent tuberculosis skin test for the 21st century? Type de document : document électronique Auteurs : Ibrahim Abubakar, Auteur ; Charlotte Jackson, Auteur ; Molebogeng X. Rangaka, Auteur Editeur : Lancet Année de publication : 2017 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 5(4) Importance : p.236-237 Langues : Anglais (eng) Catégories : [TUBER] diagnostic
[TUBER] type de tuberculose:tuberculose-maladieIndex. décimale : TU 5. Méthodes de diagnostic Résumé : The UN Sustainable Development Goals have led to global plans to end the tuberculosis epidemic. Individuals with latent tuberculosis infection are at risk of reactivation disease and onward transmission to contacts. Identification of these people before they develop active tuberculosis will, therefore, help to control the epidemic. Unfortunately, there is no gold standard diagnostic test for latent tuberculosis infection, and existing tests have poor ability to predict which individuals will go on to develop active tuberculosis. Those used at present are the tuberculin skin test (TST), which is cheap and simple to administer in the field but can be falsely positive in people who have received BCG vaccination or been exposed to non-tuberculous mycobacteria,1 and interferon γ release assays (IGRAs), which are more specific but are expensive and need specialist laboratory processing.
En ligne : http://dx.doi.org/10.1016/ S2213-2600(17)30012-7 Format de la ressource électronique : HTML, PDF Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10870 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Changing the game for multidrug-resistant tuberculosis Type de document : document électronique Auteurs : Bharathi Ghanashyam, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet num. 387(10024) Importance : p.1149-1150 Langues : Anglais (eng) Catégories : [TUBER] prévention:journée mondiale de la tuberculose
[TUBER] traitement:résistance:multirésistance
[TUBER] traitement:traitement curatifIndex. décimale : TU 8.5.1. MDR (Multi Drug Resistance / XDR (X-treme Drug Resistance) Résumé : Promising new drugs and shorter regimens for the treatment of multidrug-resistant tuberculosis are beginning to emerge. Bharathi Ghanashyam reports ahead of World TB Day.
En ligne : https://doi.org/10.1016/S0140-6736(16)30014-9 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10029 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : E-cigarette-induced lung disease : from acute to chronic Type de document : document électronique Auteurs : Florian Poschenrieder, Auteur ; Michael Rotter, Auteur ; Andreas Gschwendtner, Auteur Editeur : Lancet Année de publication : 2020 Collection : The Lancet num. 396 Importance : p.564 Présentation : ill. Langues : Anglais (eng) Catégories : [DIVERS] anatomie:corps humain:appareil respiratoire:poumon
[NICO] chimie du tabac:constituant:additif:arôme
[NICO] produit:produit à vapoter:cigarette électronique
[NICO] tabagisme:pathologie:pathologie respiratoire
[NICO] tabagisme:risqueIndex. décimale : TA 3.2.2.4 Pathologies respiratoires (sauf 3.2.2.1, 3.2.2.2, 3.2.2.3) Résumé : Case report Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9771 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : E-cigarettes and smoking cessation in real-world and clinical settings : a systematic review and meta-analysis Type de document : document électronique Auteurs : Sara Kalkhoran, Auteur ; Stanton A. Glantz, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 4(2) Importance : p.116-128 Langues : Anglais (eng) Catégories : [NICO] étude:méta-analyse
[NICO] produit:produit à vapoter:cigarette électronique
[NICO] sevrage tabagiqueIndex. décimale : TA 6.2.3.2 Autres produits En ligne : https://doi.org/10.1016/s2213-2600(15)00521-4 Format de la ressource électronique : HTML, PDF Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9428 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : E-cigarettes are less harmful than smoking Type de document : document électronique Auteurs : David, J. Nutt, Auteur ; Lauwrence, D. Phillips, Auteur ; David J.K. Balfour, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet num. 387 Importance : p. 1160-1162 Présentation : ill. Langues : Anglais (eng) Catégories : [NICO] produit:produit à fumer
[NICO] produit:produit à vapoter:cigarette électronique
[NICO] tabagisme:effet du tabac:toxicitéIndex. décimale : TA 1.1.1 Cigarettes (« normales », électroniques, aromatisées,…) Résumé : Critique de l'examen du Public Health England sur les cigarettes électroniques En ligne : https://doi.org/10.1016/S0140-6736(15)00253-6 Format de la ressource électronique : Page de l'éditeur Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9569 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study) : case-control study Type de document : document électronique Auteurs : Salim Yusuf, Auteur ; Steven Hawken, Auteur ; Stephanie Ounpuu, Auteur Editeur : Lancet Année de publication : 2004 Collection : The Lancet num. 364 Importance : 16 p. Présentation : tab.,graph. Langues : Anglais (eng) Catégories : [NICO] étude:épidémiologie
[NICO] tabagisme:risque:risque cardiovasculaireIndex. décimale : TA 3.2.2.5 Pathologies cardiovasculaires Résumé : Background Although more than 80% of the global burden of cardiovascular disease occurs in low-income and middle-income countries, knowledge of the importance of risk factors is largely derived from developed countries. Therefore, the effect of such factors on risk of coronary heart disease in most regions of the world is unknown. Methods We established a standardised case-control study of acute myocardial infarction in 52 countries, representing every inhabited continent. 15 152 cases and 14 820 controls were enrolled. The relation of smoking, history of hypertension or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins (Apo), and psychosocial factors to myocardial infarction are reported here. Odds ratios and their 99% CIs for the association of risk factors to myocardial infarction and their population attributable risks (PAR) were calculated. Findings Smoking (odds ratio 2·87 for current vs never, PAR 35·7% for current and former vs never), raised ApoB/ApoA1 ratio (3·25 for top vs lowest quintile, PAR 49·2% for top four quintiles vs lowest quintile), history of hypertension (1·91, PAR 17·9%), diabetes (2·37, PAR 9·9%), abdominal obesity (1·12 for top vs lowest tertile and 1·62 for middle vs lowest tertile, PAR 20·1% for top two tertiles vs lowest tertile), psychosocial factors (2·67, PAR 32·5%), daily consumption of fruits and vegetables (0·70, PAR 13·7% for lack of daily consumption), regular alcohol consumption (0·91, PAR 6·7%), and regular physical activity (0·86, PAR 12·2%), were all significantly related to acute myocardial infarction (p<0·0001 for all risk factors and p=0·03 for alcohol). These associations were noted in men and women, old and young, and in all regions of the world. Collectively, these nine risk factors accounted for 90% of the PAR in men and 94% in women. Interpretation Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions. This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infarction En ligne : https://doi.org/10.1016/s0140-6736(04)17018-9 Format de la ressource électronique : Page de l'éditeur Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9555 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Effect of viewing smoking in movies on adolescent smoking initiation : a cohort study Type de document : document électronique Auteurs : Madeline A. Dalton, Auteur ; James Sargent, Auteur ; Michael L. Beach, Auteur Editeur : Lancet Année de publication : 2003 Collection : The Lancet num. 362 Importance : p.281-285 Présentation : tab. Langues : Anglais (eng) Catégories : [NICO] étude
[NICO] tabagisme:aspect culturel:cinéma
[NICO] tabagisme:tabagisme actif:début du tabagismeIndex. décimale : TA 2.4.1 Enfants et jeunes Résumé : Background
Exposure to smoking in movies has been linked with adolescent smoking initiation in cross-sectional studies. We undertook a prospective study to ascertain whether exposure to smoking in movies predicts smoking initiation.
Method
We assessed exposure to smoking shown in movies in 3547 adolescents, aged 10–14 years, who reported in a baseline survey that they had never tried smoking. Exposure to smoking in movies was estimated for individual respondents on the basis of the number of smoking occurrences viewed in unique samples of 50 movies, which were randomly selected from a larger sample pool of popular contemporary movies. We successfully re-contacted 2603 (73%) students 13–26 months later for a follow-up interview to determine whether they had initiated smoking.
Findings
Overall, 10% (n=259) of students initiated smoking during the follow-up period. In the highest quartile of exposure to movie smoking, 17% (107) of students had initiated smoking, compared with only 3% (22) in the lowest quartile. After controlling for baseline characteristics, adolescents in the highest quartile of exposure to movie smoking were 2·71 (95% CI 1·73–4·25) times more likely to initiate smoking compared with those in the lowest quartile. The effect of exposure to movie smoking was stronger in adolescents with non-smoking parents than in those whose parent smoked. In this cohort, 52·2% (30·0–67·3) of smoking initiation can be attributed to exposure to smoking in movies.
Interpretation
Our results provide strong evidence that viewing smoking in movies promotes smoking initiation among adolescents.Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9774 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Supplément de E-cigarettes and smoking cessation in real-world and clinical settings / Sara Kalkhoran (2016)
Titre : Electronic cigarettes: more light, less heat needed Type de document : document électronique Auteurs : Steven L. Bernstein, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 4(2) Importance : p.85-87 Langues : Anglais (eng) Catégories : [NICO] produit:produit à vapoter:cigarette électronique Index. décimale : TA 1.1.1 Cigarettes (« normales », électroniques, aromatisées,…) En ligne : https://doi.org/10.1016/s2213-2600(16)00010-2 Format de la ressource électronique : Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9427 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Expected effects of adopting a 9 month regimen for multidrug-resistant tuberculosis : a population modelling analysis Type de document : document électronique Auteurs : Emily A. Kendall, Auteur ; Anthony T. Fojo, Auteur ; David W. Dowdy, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 16 Importance : p.P191-199 Présentation : ill. ; tab. ; graph. Langues : Anglais (eng) Catégories : [DIVERS] association:association internationale:Organisation Mondiale de la Santé
[TUBER] traitement:résistance:multirésistance
[TUBER] traitement:traitement curatifIndex. décimale : TU 8.5.1. MDR (Multi Drug Resistance / XDR (X-treme Drug Resistance) Résumé : Background
In May, 2016, WHO endorsed a 9 month regimen for multidrug-resistant tuberculosis that is cheaper and potentially more effective than the conventional, longer (20–24 month) therapy. We aimed to investigate the population-level implications of scaling up this new regimen.
Methods
In this population modelling analysis, we developed a dynamic transmission model to simulate the introduction of this short-course regimen as an instantaneous switch in 2016. We projected the corresponding percentage reduction in the incidence of multidrug-resistant tuberculosis by 2024 compared with continued use of longer therapy. In the primary analysis in a representative southeast Asian setting, we assumed that the short-course regimen would double treatment access (through savings in resources or capacity) and achieve long-term efficacy at levels seen in preliminary cohort studies. We then did extensive sensitivity analyses to explore a range of alternative scenarios.
Findings
Under the optimistic assumptions in the primary analysis, the incidence of multidrug-resistant tuberculosis in 2024 would be 3·3 (95% uncertainty range 2·2–5·6) per 100 000 population with the short-course regimen and 4·3 (2·9–7·6) per 100 000 population with continued use of longer therapy—ie, the short-course regimen could reduce incidence by 23% (10–38). Incidence would be reduced by 14% (4–28) if the new regimen affected only treatment effectiveness and by 11% (3–24) if it affected only treatment availability. Under more pessimistic assumptions, the short-course regimen would have minimal effect and even potential for harm—eg, when 30% of patients are ineligible for the new regimen because of second-line drug resistance, we projected a change in incidence of −2% (−20 to +28). The new regimen's effect was greater in settings with more ongoing transmission of multidrug-resistant tuberculosis, but results were otherwise similar across settings with different levels of tuberculosis incidence and prevalence of multidrug resistance.
Interpretation
The short-course regimen has potential to substantially lessen the multidrug-resistant tuberculosis epidemic, but this effect depends on its long-term efficacy, its ability to expand treatment access, and the role of second-line drug resistance.
Funding
US National Institutes of Health and Bill & Melinda Gates Foundation.En ligne : http://dx.doi.org/10.1016/S2213-2600(16)30423-4 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10864 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Harvard launches new global health centre in Dubai Type de document : texte imprimé Auteurs : Talha Burki, Auteur Editeur : Lancet Année de publication : 2015 Collection : The Lancet num. 386 Importance : 1 p. Langues : Anglais (eng) Catégories : [DIVERS] géographie:Asie:Proche et Moyen-Orient
[TUBER] type de tuberculose:tuberculose-maladieIndex. décimale : TU 3. Stratégies et programmes de prévention et de contrôle Résumé : A new initiative by Harvard Medical School and collaborators aims to bolster the delivery of
global health interventions to populations in the Middle East and beyond. Talha Burki reports.En ligne : https://doi.org/10.1016/S0140-6736(15)00609-1 Format de la ressource électronique : Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9309 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : High-dose rifampicin, moxifloxacin, and SQ109 for treating tuberculosis : a multi-arm, multi-stage randomised controlled trial Type de document : document électronique Auteurs : Martin J. Boeree, Auteur ; Norbert Heinrich, Auteur ; Rob Aarnoutse, Auteur Editeur : Lancet Année de publication : 2017 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. 17 Importance : p. 39-49 Présentation : ill. ; tab. ; graph. Langues : Anglais (eng) Catégories : [TUBER] étude:recherche:recherche clinique:essai clinique randomisé
[TUBER] traitement:traitement curatif
[TUBER] type de tuberculose:tuberculose-maladie:tuberculose pulmonaireIndex. décimale : TU 8.2. Traitement curatif Résumé : Background: Tuberculosis is the world’s leading infectious disease killer. We aimed to identify shorter, safer drug regimens for the treatment of tuberculosis.
Methods: We did a randomised controlled, open-label trial with a multi-arm, multi-stage design. The trial was done in seven sites in South Africa and Tanzania, including hospitals, health centres, and clinical trial centres. Patients with newly diagnosed, rifampicin-sensitive, previously untreated pulmonary tuberculosis were randomly assigned in a 1:1:1:1:2 ratio to receive (all orally) either 35 mg/kg rifampicin per day with 15–20 mg/kg ethambutol, 20 mg/kg rifampicin per day with 400 mg moxifl oxacin, 20 mg/kg rifampicin per day with 300 mg SQ109, 10 mg/kg rifampicin per day with 300 mg SQ109, or a daily standard control regimen (10 mg/kg rifampicin, 5 mg/kg isoniazid, 25 mg/kg pyrazinamide, and 15–20 mg/kg ethambutol). Experimental treatments were given with oral 5 mg/kg isoniazid and 25 mg/kg pyrazinamide per day for 12 weeks, followed by 14 weeks of 5 mg/kg isoniazid and 10 mg/kg rifampicin per day. Because of the orange discoloration of body fluids with higher doses of rifampicin it was not possible to mask patients and clinicians to treatment allocation. The primary endpoint was time to culture conversion in liquid media within 12 weeks. Patients without evidence of rifampicin resistance on phenotypic test who took at least one dose of study treatment and had one positive culture on liquid or solid media before or within the fi rst 2 weeks of treatment were included in the primary analysis (modified intention to treat). Time-to-event data were analysed using a Cox proportional-hazards regression model and adjusted for minimisation variables. The proportional hazard assumption was tested using Schoelfeld residuals, with threshold p<0·05 for non-proportionality. The trial is registered with ClinicalTrials.gov (NCT01785186).
Findings: Between May 7, 2013, and March 25, 2014, we enrolled and randomly assigned 365 patients to diff erent treatment arms (63 to rifampicin 35 mg/kg, isoniazid, pyrazinamide, and ethambutol; 59 to rifampicin 10 mg/kg, isoniazid, pyrazinamide, SQ109; 57 to rifampicin 20 mg/kg, isoniazid, pyrazinamide, and SQ109; 63 to rifampicin 10 mg/kg, isoniazid, pyrazinamide, and moxifl oxacin; and 123 to the control arm). Recruitment was stopped early in the arms containing SQ109 since prespecifi ed effi cacy thresholds were not met at the planned interim analysis. Time to stable culture conversion in liquid media was faster in the 35 mg/kg rifampicin group than in the control group (median 48 days vs 62 days, adjusted hazard ratio 1·78; 95% CI 1·22–2·58, p=0·003), but not in other experimental arms. There was no diff erence in any of the groups in time to culture conversion on solid media. 11 patients had treatment failure or recurrent disease during post-treatment follow-up: one in the 35 mg/kg rifampicin arm and none in the moxifl oxacin arm. 45 (12%) of 365 patients reported grade 3–5 adverse events, with similar proportions in each arm.
Interpretation: A dose of 35 mg/kg rifampicin was safe, reduced the time to culture conversion in liquid media, and could be a promising component of future, shorter regimens. Our adaptive trial design was successfully implemented in a multi-centre, high tuberculosis burden setting, and could speed regimen development at reduced cost.
Funding: The study was funded by the European and Developing Countries Clinical Trials partnership (EDCTP), the German Ministry for Education and Research (BmBF), and the Medical Research Council UK (MRC).En ligne : http://dx.doi.org/10.1016/ S1473-3099(16)30274-2 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10863 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
