Methionine and vitamin B-complex ameliorate antitubercular drugs-induced toxicity in exposed patients

Pharmacol Res Perspect. 2017 Oct;5(5):e00360. doi: 10.1002/prp2.360.

Abstract

Tuberculosis therapy utilizes drugs that while effective cause treatment-related toxicity. Modulation of antitubercular drugs-induced toxicity by methionine and vitamin B-complex in patients was evaluated. 285 treatment-naïve tuberculosis patients at the Chest Clinics of Infectious Diseases Hospital, Yaba and General Hospital, Lagos in Lagos, Nigeria was prospectively recruited and allotted into test (antitubercular medicines, methionine and vitamin B-complex) and control groups (antitubercular medicines). Data on adverse drug reactions and blood samples were collected at initiation, 2 months and 6 months, and then analyzed. Red blood cells and packed cell volume were significantly higher (P < 0.05) in the test group compared to control at 6 months of therapy. At the end of 2 months, results showed a significant decrease (P < 0.001) in aspartate aminotransferase, alkaline phosphatase, alanine aminotransferase, urea, creatinine and total bilirubin in the test group compared to control. Reduced glutathione and superoxide dismutase were significantly increased (P < 0.001) and malondialdehyde significantly decreased (P < 0.001) in the test versus control groups at the end of 2 and 6 months. Adverse drug reactions were significantly lower (P < 0.001) in the test group (32.4%) compared to control group (56.2%), with 1 death. Hepatotoxicity was significantly higher (P = 0.026) in control (6.9%), compared to test group (0%). Alcohol and cigarette smoking were significantly (P = 0.019 and P = 0.027) associated with the occurrence of adverse drug reactions. Methionine and vitamin B-complex modulated hepatic, renal, hematological, antioxidant indices and adverse effects in patients administered antitubercular medicines. Such interventions can enhance compliance and better treatment outcomes in tuberculosis patients.

Keywords: Antioxidants; biomarkers; drug toxicity; methionine; modulation; tuberculosis.

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Alkaline Phosphatase / blood
  • Antitubercular Agents / adverse effects*
  • Antitubercular Agents / pharmacology
  • Aspartate Aminotransferases / blood
  • Drug Therapy, Combination
  • Drug-Related Side Effects and Adverse Reactions / blood
  • Drug-Related Side Effects and Adverse Reactions / drug therapy*
  • Drug-Related Side Effects and Adverse Reactions / metabolism
  • Female
  • Humans
  • Male
  • Methionine / administration & dosage*
  • Methionine / pharmacology
  • Middle Aged
  • Nigeria
  • Prospective Studies
  • Tuberculosis / blood
  • Tuberculosis / drug therapy*
  • Tuberculosis / metabolism
  • Vitamin B Complex / administration & dosage*
  • Vitamin B Complex / pharmacology
  • Young Adult

Substances

  • Antitubercular Agents
  • Vitamin B Complex
  • Methionine
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Alkaline Phosphatase