A Cochrane review [Abstract] 1 included 5 studies with a total of 924 subjects. 5% of participants were HIV positive. Two trials were conducted in Africa (one in each of Uganda and South Africa), one in Hong Kong, one in Poland, and one was a multicentre trial involving participants in Argentina, Brazil, and Thailand. Rifabutin was compared to rifampicin in regimens containing different combinations of companion drugs. Only one small trial was methodologically adequate. There was no statistically significant difference between the regimens for cure (RR 1.00, 95% CI 0.96 to 1.04; 2 trials, n=553) or relapse (RR 1.23, 95% CI 0.45 to 3.35; 2 trials, n=448). The number of adverse events was not significantly different (RR 1.42, 95% CI 0.88 to 2.31; 3 trials, n=714), though the RR increased with rifabutin dose: 150 mg (RR 0.98, 95% CI 0.45 to 2.12; 2 trials, n=264); and 300 mg (RR 1.78, 95% CI 0.94 to 3.34; 2 trials, n=450). However, lack of dose adjustment by weight in the relevant trials complicates interpretation of this relationship.
Comment: The quality of evidence is downgraded by limitations in study quality (inadequate or unclear allocation concealment, inadequate intention-to-treat adherence) and by imprecise results (limited study size for each comparison).
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