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All Journal Jurnal Respirologi Indonesia Malang Respiratory Journal
Felim, Ris Raihan
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other

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Non-Genetic Risk Factors for First-Line Anti-Tuberculosis Drug-Induced Liver Injury in Active Pulmonary Tuberculosis Patients: A Systematic Review and Meta-Analysis Ilham, Ahmad Fadhil; Felim, Ris Raihan; Akbar, Fadhian; Burhan, Erlina
Jurnal Respirologi Indonesia Vol 45 No 3 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i3.693

Abstract

Background: Tuberculosis is still one of the leading causes of poor health and death worldwide. Drug-induced liver injury (DILI) is an important and serious side effect of anti-tuberculosis treatment and can cause non-adherence of patients to the treatment. To reduce the possibility of patients developing DILI, the risk factors must be identified. Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Inclusion and exclusion criteria were used to screen and filter the articles that were obtained from literature searching performed through several journal databases. The extracted data were analyzed qualitatively and quantitatively. The quality of each study was also assessed using the modified Newcastle Ottawa Scale (NOS). The protocol for this systematic review has been registered with PROSPERO CRD42022384892. Results: The results showed that, of the 13 studies analyzed qualitatively, 11 studies with a total of 4,920 patients were selected for quantitative analysis. The factors analyzed and the results were female gender (OR=1.10; 95% CI=0.72-1.67; P=0.65), age over 40 years (OR=1.60; 95% CI=1.04-2.46; P=0.03), body mass index less than 18.5 kg/m2 (OR=0.96; 95% CI=0.52-1.79; P=0.9), active smoking (OR=0.71; 95% CI=0.34-1.49; P=0.36), frequent alcohol intake (OR=1.44; 95% CI=0.61-3.42; P=0.41), hepatitis B (OR=3.42; 95% CI=1.72-6.79; P<0.001]), and hepatitis C (OR=12.87; 95% CI=6.67-24.86; P<0.00001]). Conclusion: In conclusion, the evidence from this review suggests that older age, hepatitis B, and hepatitis C are significant risk factors thought to increase the incidence of DILI in active pulmonary tuberculosis patients taking first-line anti-tuberculosis regimens.
Chronic Obstructive Pulmonary Disease Exacerbation Complicated with Pneumonia and Lung Cancer: An Evidence-based Case Report of Erdosteine Role in the Management of Complex COPD Ilham, Ahmad Fadhil; Rakasiwi, Muhammad Ilham Dhiya; Felim, Ris Raihan; Arfan, Ahmad; Burhan, Erlina
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.05

Abstract

Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are strongly associated with poor health status and morbidity. Erdosteine is a mucolytic agent that also has anti-inflammatory, antioxidant and antibacterial effects. This case report aims to evaluate the role of erdosteine in the prevention and treatment of acute exacerbations of complex COPD case. Case: A 73-year-old male arrived at the emergency department with an increased difficulty in breathing that had deteriorated over the previous 5 days, and had a history of heavy smoking for more than 40 years. Following a thorough examination, he was diagnosed with acute exacerbation of COPD (Anthonisen criteria type 2) in clinical group E, pneumonia, along with stage IIIA right lung tumor (T4N1Mx), and received erdosteine inhalation as part of his treatment. Discussion: A comprehensive search of journal databases (PubMed, EMBASE, CENTRAL, EBSCO Medline, Scopus, and ProQuest) was conducted using specific keywords, critical appraisal based on the Oxford Center for Evidence-Based Medicine. Article selection resulted in 1 systematic review article for the prevention of acute exacerbations and 1 systematic review article for the management of acute exacerbations of COPD. In patients with stable COPD, administration of erdosteine in the standard COPD regimen significantly reduced the risk of exacerbations (RR=0.65; p=0.01), while in patients with acute exacerbations of COPD, erdosteine increased treatment success (OR=3.2; p<0.0001). Conclusion: Erdosteine may serve as a therapeutic choice for COPD patients in preventing or managing acute exacerbations.
Co-Authors Akbar, Fadhian Arfan, Ahmad Erlina Burhan Ilham, Ahmad Fadhil Rakasiwi, Muhammad Ilham Dhiya