{"id":24043,"date":"2023-06-21T04:41:00","date_gmt":"2023-06-20T20:41:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24043"},"modified":"2023-06-21T06:13:10","modified_gmt":"2023-06-20T22:13:10","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%8d%95%e5%89%82%e9%87%8f%e5%88%a9%e7%a6%8f%e5%96%b7%e4%b8%81%e7%94%a8%e4%ba%8e%e9%ba%bb%e9%a3%8e%e5%ae%b6%e5%86%85%e6%8e%a5%e8%a7%a6%e8%80%85","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24043","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u5355\u5242\u91cf\u5229\u798f\u55b7\u4e01\u7528\u4e8e\u9ebb\u98ce\u5bb6\u5185\u63a5\u89e6\u8005\u7684\u9884\u9632"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Single-Dose Rifapentine in Household Contacts of Patients with Leprosy<\/h1>\n\n\n\n

Le Wang, Hongsheng Wang, Liangbin Yan, et al<\/h3>\n\n\n\n

N Engl J Med 2023; 388:1843-1852
DOI: 10.1056\/NEJMoa2205487<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h2>\n\n\n\n

Previous studies have suggested that a single dose of rifampin has protective effects against leprosy in close contacts of patients with the disease. Rifapentine was shown to have greater bactericidal activity against\u00a0Mycobacterium leprae<\/em>\u00a0than rifampin in murine models of leprosy, but data regarding its effectiveness in preventing leprosy are lacking.<\/p>\n\n\n\n

\u80cc\u666f<\/strong><\/p>\n\n\n\n

\u4e4b\u524d\u7684\u7814\u7a76\u63d0\u793a\uff0c\u5728\u9ebb\u98ce\u7684\u5bc6\u5207\u63a5\u89e6\u8005\u4e2d\uff0c\u5355\u5242\u91cf\u5229\u798f\u5e73\u6709\u4fdd\u62a4\u4f5c\u7528\uff0c\u53ef\u9884\u9632\u9ebb\u98ce\u3002\u5728\u9ebb\u98ce\u5c0f\u9f20\u6a21\u578b\u4e2d\uff0c\u5229\u798f\u55b7\u4e01\u5bf9\u9ebb\u98ce\u5206\u679d\u6746\u83cc\u7684\u6740\u83cc\u6d3b\u6027\u8d85\u8fc7\u5229\u798f\u5e73\uff0c\u4f46\u76ee\u524d\u7f3a\u4e4f\u5173\u4e8e\u5176\u9884\u9632\u9ebb\u98ce\u7684\u6709\u6548\u6027\u6570\u636e<\/p>\n\n\n\n

METHODS<\/h2>\n\n\n\n

We conducted a cluster-randomized, controlled trial to investigate whether single-dose rifapentine is effective in preventing leprosy in household contacts of patients with leprosy. The clusters (counties or districts in Southwest China) were assigned to one of three trial groups: single-dose rifapentine, single-dose rifampin, or control (no intervention). The primary outcome was the 4-year cumulative incidence of leprosy among household contacts.<\/p>\n\n\n\n

\u65b9\u6cd5<\/strong><\/p>\n\n\n\n

\u6211\u4eec\u5f00\u5c55\u4e86\u4e00\u9879\u6574\u7fa4\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff0c\u7814\u7a76\u5355\u5242\u91cf\u5229\u798f\u55b7\u4e01\u5bf9\u9ebb\u98ce\u5bb6\u5185\u63a5\u89e6\u8005\u7684\u662f\u5426\u6709\u9884\u9632\u4f5c\u7528\u3002\u6574\u7fa4\uff08\u4e2d\u56fd\u897f\u5357\u5730\u533a\u7684\u53bf\u6216\u533a\uff09\u88ab\u5206\u914d\u5230\u4ee5\u4e0b\u4e09\u4e2a\u8bd5\u9a8c\u7ec4\u4e4b\u4e00\uff1a\u5355\u5242\u91cf\u5229\u798f\u55b7\u4e01\u3001\u5355\u5242\u91cf\u5229\u798f\u5e73\u6216\u5bf9\u7167\uff08\u65e0\u5e72\u9884\uff09\u3002\u4e3b\u8981\u7ed3\u5c40\u662f\u5bb6\u5185\u63a5\u89e6\u8005\u4e2d\u9ebb\u98ce\u76844\u5e74\u7d2f\u79ef\u53d1\u75c5\u7387\u3002<\/a><\/p>\n\n\n\n

RESULTS<\/h2>\n\n\n\n

A total of 207 clusters comprising 7450 household contacts underwent randomization; 68 clusters (2331 household contacts) were assigned to the rifapentine group, 71 (2760) to the rifampin group, and 68 (2359) to the control group. A total of 24 new cases of leprosy occurred over the 4-year follow-up, for a cumulative incidence of 0.09% (95% confidence interval [CI], 0.02 to 0.34) with rifapentine (2 cases), 0.33% (95% CI, 0.17 to 0.63) with rifampin (9 cases), and 0.55% (95% CI, 0.32 to 0.95) with no intervention (13 cases). In an intention-to-treat analysis, the cumulative incidence in the rifapentine group was 84% lower than that in the control group (cumulative incidence ratio, 0.16; multiplicity-adjusted 95% CI, 0.03 to 0.87; P=0.02); the cumulative incidence did not differ significantly between the rifampin group and the control group (cumulative incidence ratio, 0.59; multiplicity-adjusted 95% CI, 0.22 to 1.57; P=0.23). In a per-protocol analysis, the cumulative incidence was 0.05% with rifapentine, 0.19% with rifampin, and 0.63% with no intervention. No severe adverse events were observed.<\/p>\n\n\n\n

\u7ed3\u679c<\/strong><\/p>\n\n\n\n

\u5171207\u4e2a\u7fa4\uff08\u5305\u62ec7450\u540d\u5bb6\u5185\u63a5\u89e6\u8005\uff09\u88ab\u968f\u673a\u5206\u7ec4\uff1b68\u4e2a\u7fa4\uff082331\u540d\u5bb6\u5185\u63a5\u89e6\u8005\uff09\u88ab\u5206\u914d\u5230\u5229\u798f\u55b7\u4e01\u7ec4\uff0c71\u4e2a\u7fa4\uff082760\u540d\uff09\u88ab\u5206\u914d\u5230\u5229\u798f\u5e73\u7ec4\uff0c68\u4e2a\u7fa4\uff082359\u540d\uff09\u88ab\u5206\u914d\u5230\u5bf9\u7167\u7ec4\u30024\u5e74\u968f\u8bbf\u671f\u95f4\u5171\u670924\u4f8b\u9ebb\u98ce\u65b0\u53d1\u75c5\u4f8b\uff0c\u5728\u5229\u798f\u55b7\u4e01\u7ec4\uff082\u4f8b\uff09\u3001\u5229\u798f\u5e73\u7ec4\uff089\u4f8b\uff09\u548c\u672a\u5e72\u9884\u7ec4\uff0813\u4f8b\uff09\u4e2d\uff0c\u7d2f\u79ef\u53d1\u75c5\u7387\u5206\u522b\u4e3a0.09%\uff0895%\u7f6e\u4fe1\u533a\u95f4[CI]\uff0c0.02~0.34\uff09\u30010.33%\uff0895% CI\uff0c0.17~0.63\uff09\u548c0.55%\uff0895% CI\uff0c0.32~0.95\uff09\u3002\u5728\u610f\u5411\u6027\u6cbb\u7597\u5206\u6790\u4e2d\uff0c\u5229\u798f\u55b7\u4e01\u7ec4\u7684\u7d2f\u79ef\u53d1\u75c5\u7387\u6bd4\u5bf9\u7167\u7ec4\u4f4e84%\uff08\u7d2f\u79ef\u53d1\u75c5\u7387\u6bd4\uff0c0.16\uff1b\u7ecf\u591a\u91cd\u6821\u6b63\u768495% CI\uff0c0.03~0.87\uff1bP=0.02\uff09\uff1b\u5229\u798f\u5e73\u7ec4\u548c\u5bf9\u7167\u7ec4\u7684\u7d2f\u79ef\u53d1\u75c5\u7387\u65e0\u663e\u8457\u5dee\u5f02\uff08\u7d2f\u79ef\u53d1\u75c5\u7387\u6bd4\uff0c0.59\uff1b\u7ecf\u591a\u91cd\u6821\u6b63\u768495% CI\uff0c0.22~1.57\uff1bP=0.23\uff09\u3002\u5728\u7b26\u5408\u65b9\u6848\u5206\u6790\u4e2d\uff0c\u5728\u5229\u798f\u55b7\u4e01\u7ec4\u3001\u5229\u798f\u5e73\u7ec4\u548c\u65e0\u5e72\u9884\u7ec4\u4e2d\uff0c\u7d2f\u79ef\u53d1\u75c5\u7387\u5206\u522b\u4e3a0.05%\u30010.19%\u548c0.63%\u3002\u672a\u89c2\u5bdf\u5230\u4e25\u91cd\u4e0d\u826f\u4e8b\u4ef6\u3002<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

CONCLUSIONS<\/h2>\n\n\n\n

The incidence of leprosy among household contacts over 4 years was lower with single-dose rifapentine than with no intervention. (Funded by the Ministry of Health of China and the Chinese Academy of Medical Sciences; Chinese Clinical Trial Registry number,\u00a0ChiCTR-IPR-15007075. opens in new tab<\/a>.)<\/p>\n\n\n\n

\u7ed3\u8bba<\/strong><\/p>\n\n\n\n

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ORIGINAL ARTICLE Single-Dose Rifapentine in Household C […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24043"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24043"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24043\/revisions"}],"predecessor-version":[{"id":24044,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24043\/revisions\/24044"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24043"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24043"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24043"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}