Is hypothyroidism rare in multidrug resistance tuberculosis patients on treatment? A systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Hypothyroidism is one of the adverse drug reactions that associated with Multidrug Resistant Tuberculosis (MDR-TB) medications. Extremely variable magnitude of hypothyroidism in MDR-TB patients has been reported from different parts of the world. However, there is no evidence that tried to estimate the pooled prevalence of hypothyroidism to confirm the rareness of hypothyroidism in MDR-TB patients on treatment. Therefore, we did a systematic review and meta-analysis to estimate the prevalence of hypothyroidism in MDR-TB patients on treatment, and to summarize the demographic and clinical characteristics of the patients. METHODS: We conducted a systematic review and meta-analysis on studies reported around the world on the prevalence of hypothyroidism in MDR-TB patients on treatment. We searched electronic databases: PubMed/Medline, EMBASE, CINAHL, Science Direct, Academic Search Complete and Google scholar for English language articles without limiting publication year. We also reviewed the bibliographies of relevant studies and conducted an electronic search for relevant conference abstracts. Eligible studies were cross-sectional and cohort studies that included at least five participants. We used a random-effects model to estimate the pooled prevalence of hypothyroidism. The registration number of this review study protocol is CRD42018109237. RESULTS: We included 30 studies and pooled data on a total of 6,241 MDR-TB patients. The crude prevalence of hypothyroidism was extremely heterogeneous. The pooled prevalence of hypothyroidism in MDR-TB patients on treatment was 17.0% (95% CI: 13.0-20.0). Ethionamide and para-aminosalicylic acid (PAS) were the most frequently reported drugs that associated with the occurrence of hypothyroidism. CONCLUSION: This review revealed that hypothyroidism is not a rare adverse drug reaction in MDR-TB patients on treatment. Ethionamide and PAS were the most frequently reported drugs that associated with the occurrence of hypothyroidism. Screening of hypothyroidism in MDR-TB patients on treatment is important while targeting patients on Ethionamide and PAS based treatment regimen.
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A meta-analysis on 6,241 multidrug-resistant tuberculosis patients showed that primary hypothyroidism prevalence in MDR-TB patients averaged 17.0%, with ethionamide and para-aminosalicylic acid being the most frequently reported drugs associated with hypothyroidism.
“After initial reports (48–50), a meta-analysis on 6,241 MDR-TB patients (31) showed that PH prevalence in MDR-TB patients averaged 17.0%, with ethionamide and PAS were the most frequently reported drugs associated with hypothyroidism.”
From L-T4 therapy in the presence of pharmacological interferents (2020) · cites this paper as [31]
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- Authors
- Tola, H. H., Holakouie-Naieni, K., Lejisa, T., Mansournia, M. A., Yaseri, M., Tesfaye, E., & Mola, M.
- Affiliations
- Ethiopian Public Health Institute (ET)
- Tehran University of Medical Sciences (IR)
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-06-18
- Volume
- 14
- Issue
- 6
- Pages
- e0218487
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6581430
- OpenAlex
- W2951105164
- Cited by
- 11
- References
- 73
- Citations by year
- 2025: 2 · 2024: 2 · 2022: 4 · 2021: 2 · 2020: 1
- FWCI
- 0.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Greater South Information System
- Funders
- Tehran University of Medical Sciences and Health Services
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- hypothyroidism, multidrug-resistant tuberculosis, adverse drug reactions, ethionamide, para-aminosalicylic acid, drug-induced hypothyroidism, prevalence, hypothyroidism screening, tuberculosis treatment
- MeSH terms
- Antitubercular Agents, Cross-Sectional Studies, Ethionamide, Humans, Hypothyroidism, Aminosalicylic Acid, Risk Factors, Tuberculosis, Multidrug-Resistant, Drug-Related Side Effects and Adverse Reactions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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