Abstract:

Objective  To evaluate the efficacy and safety of rifapentine(RPT) and rifampicin(RFP) in treatment of pulmonary tuberculosis with Meta-analysis,and provide a reliable and scientific evidence of evidence-based medicine for c
linical application of RPT  in tuberculosis treatment. Methods The articles related to the efficacy and safety of RPT and RFP in the treatment of pulmonary tuberculosis,and randomized clinical controlled trials （RCT）or clinical controlled trials（CCT）published in the openly journals either in Chinese or English from 1999 to July 2010 were searched by computer. The databases were as follows:Ovid-medline,CBMdisc,Pubmed,CNKI,Wanfang database and Weipu database. Some pulmonary tuberculosis journals which didn’t publish on line had also been searched by hand. Results There were 18 RCTs and 6 CCTs were finally selected. In the aspect of efficacy,the  2-month sputum negative conversion rate of the primary treated tuberculosis cases,the obvious effective rate and curable rate of cavity at the end of   treatment period of  relapse tuber
culosis and recurrence rate of tuberculosis in the following 2 or 3 years after  treatment period of the relapse tuberculosis cases were all significantly different between RPT and RFP groups,respectively（P<0.05）. RPT was more effective than RFP . There were no significant differences between two groups on other indexes,such as 2-month sputum negative conversion rate of the relapse tuberculosis cases,and sputum negative conversion rates both of the primary and relapse tuberculosis cases at the end of treatment  period of tuberculosis,and obvious effective rate and curable rate of cavity at the end of the treatment period of the primary treated tuberculosis cases（P>0.05）. As for the evaluation of safety，the combined analysis results showed that  skin rash and drug fever showed no significant differences（P>0.05），other indexes  all showed significant differences between two groups (P<0.05),such as total drug side-effects，abnormal liver function，ALT elevating，serum bilirubin elevating,gastrointestinal adverse reactions,and discontinuation of medication. RPT had less side effects than RFP. Conclusion RPT is safe and effective to treat pulmonary tuberculosis,especially for relapse cases. Besides,the patients possibly have better tolerance and adherence to RPT than RFP.

Key words: rifapentine;rifampincin;tuberculosis;Meta-analysis