Evidence map›Paper›PMID 42746387›Full record

ArticleIJTLD open2026

Anaemia, hypoalbuminemia, and risk of cycloserine-associated neuropsychiatric toxicity in a shortened oral regimen for multidrug/rifampicin-resistant TB.

E Q L Shen, M Rashitov, E Algozhina, N Arlyapova, A Skrahina, A LaHood, L Trevisi, E Osso, M Romo, K J Seung and 4 more

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Article in IJTLD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

E Q L ShenHarvard Medical School, Boston, MA, USA.
M RashitovPartners In Health Kazakhstan, Almaty, Kazakhstan.
E AlgozhinaPartners In Health Kazakhstan, Almaty, Kazakhstan.
N ArlyapovaPartners In Health, Boston, MA, USA.
A SkrahinaThe Republican Scientific and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus.
A LaHoodDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
L TrevisiDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
E OssoDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
M RomoDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
K J SeungPartners In Health, Boston, MA, USA.
C D MitnickPartners In Health, Boston, MA, USA.
M L RichPartners In Health, Boston, MA, USA.
M F FrankeDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Y AlgozhinPartners In Health Kazakhstan, Almaty, Kazakhstan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAll-oral shortened regimens for multidrug/rifampicin-resistant TB (MDR/RR-TB) commonly include cycloserine, which is associated with neuropsychiatric toxicity. Predictors of cycloserine-related adverse events remain poorly defined. We assessed whether baseline anaemia or hypoalbuminemia predict neuropsychiatric toxicity.

methodsWe conducted a prospective cohort study of three 9-month standardised MDR/RR-TB regimens in Kazakhstan. Regimens shared a core of a fluoroquinolone, bedaquiline, and linezolid; one regimen included cycloserine. Neuropsychiatric adverse events of special interest (AESIs) included peripheral neuropathy, seizures, and psychosis. We conducted logistic regression to calculate associations between baseline anaemia and hypoalbuminemia and neuropsychiatric or central nervous system (CNS)-specific AESIs.

resultsIn 556 cycloserine-treated individuals, 29 (5.2%) developed neuropsychiatric AESIs. Adjusted odds ratios comparing anaemia vs. no anaemia were 2.40 (95% confidence interval [CI]: 1.01-5.72) for neuropsychiatric AESIs and 2.71 (95% CI: 0.74-9.91) for CNS-specific AESIs. Adjusted odds ratios for grade ≥2 hypoalbuminemia were 3.59 (95% CI: 0.88-14.60) and 7.40 (95% CI: 1.58-34.66), respectively. In 146 individuals without cycloserine, neuropsychiatric AESI occurred in 0/49 with anaemia versus 5/97 without anaemia (0% vs 5.2%;

conclusionsBaseline anaemia and hypoalbuminemia were associated with increased neuropsychiatric toxicity risk during treatment with a cycloserine-containing regimen. Whether these associations are specific to cycloserine merits further study.

Indexed as

drug resistancedrug toxicityMDR/RR-TBneuropsychiatric toxicitytuberculosis

Identifiers

PMID42746387
PMCPMC13577210

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.