DLCO, spirometry and PET/CT findings after completing tuberculosis treatment - preliminary findings of StatinTB/ExtendTB trial

Résumé fourni par la source

Morbidity and mortality rates after tuberculosis (TB) remain elevated. Persistent lung inflammation (PLI) has been associated with TB relapse. The ongoing StatinTB trial (NCT04147286), evaluates safety/efficacy of 40 mg atorvastatin to reduce PLI after TB treatment in HIV-/HIV+ adults measured by 18F-FDG-PET/CT, with a total follow-up of 96 weeks. We report findings at time of enrolment into StatinTB/ExtendTB of the first 106 participants. Participants with clinical response to TB treatment and a negative sputum culture for TB at 16 weeks were screened after completing 24 weeks of treatment for drug-sensitive TB. Complete pulmonary function and PLI were measured using EasyOne Pro®Lab and PET/CT. PLI was defined as total lung glycolysis (TLG) ≥50 SUVbw*mL. StatinTB/ExtendTB are conducted according to ICH-GCP. Of the 106 participants (32.1% women) aged 34.8±11.3 years who underwent PET/CT, 20.8% were HIV+, 57.5% smokers (4.6±4.2 pack years), 28.3% had previous TB; 13.2% reported ongoing cough and 8.5% shortness of breath. PLI was present in 50.0% of participants (mean TLG of 343.4±375.6 SUVbw*mL). Diffusing capacity of the lung for carbon monoxide (DLCO) was consistently reduced in participants with PLI (DLCO%Pred 73.2% vs. 94.6%; p=0.0001), as was FVC%Pred (81.5% vs. 95.6%; p=0.0001); FEV1%Pred was 78.0% vs 93.2%, p=0.0001. After accounting for other variables including HIV, smoking, FEV1 and FVC, every one percent increase in DLCO%Pred remained independently associated with a decrease of 4.7 SUVbw*mL of TLG (p=0.017). PLI is present in half of participants. Impaired DLCO is associated with PLI, in adults who have completed a 24-week treatment regimen for TB.

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