Acceptability of a clofazimine tablet in children with rifampicin-resistant TB in three high-burden countries.

IJTLD open Pub Date : 2025-08-13 eCollection Date: 2025-08-01 DOI:10.5588/ijtldopen.25.0309
L Viljoen, H R Draper, N T Castillo-Carandang, N Suryavanshi, A Marthinus, A M A Cheong, J D D Ocampo, G Dhumal, S Bagchi, D T Wademan, A Kinikar, M Paradkar, M V G Frias, D J O Casalme, A C Hesseling, A J Garcia-Prats, M Palmer, G Hoddinott
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Abstract

Background: Rifampicin-resistant TB (RR-TB) in children is frequently treated with clofazimine (CFZ), widely available as a 100mg gel capsule. This formulation is challenging to administer and is poorly acceptable to children and caregivers. Poor acceptability may negatively impact adherence and treatment outcomes. We describe the acceptability of a novel 50mg CFZ tablet formulation among children in South Africa, India, and the Philippines.

Methods: Mixed methods assessments were completed in a moxifloxacin and CFZ safety and pharmacokinetics trial in children with RR-TB. Quantitative data were collected from 36 participants at 4 timepoints. A sub-sample of 26 child/caregiver dyads participated in ∼4 qualitative interviews. Descriptive statistics and thematic analysis were employed.

Findings: The median age of n=36 participants (South Africa n=20; India n=6; the Philippines n=10) was 4.9 years. The majority (29/36) received a CFZ gel capsule prior to switching to the tablet formulation. The 50mg tablet had better acceptability scores for taste (p=0.035), smell (p=0.035), and ease of swallowing (p=0.02) compared to gel capsules. Participants described the tablet formulation as easier to administer/take without a lingering smell or taste. Limited concerns were noted on staining.

Conclusion: The novel 50mg CFZ tablet has better acceptability and should be prioritised for children wherever possible.

Abstract Image

Abstract Image

在三个高负担国家,氯法齐明片剂对患有利福平耐药结核病的儿童的可接受性。
背景:儿童利福平耐药结核病(r -TB)经常用氯法齐明(CFZ)治疗,氯法齐明是一种100mg的凝胶胶囊。这种配方很难管理,儿童和照顾者很难接受。较差的可接受性可能会对依从性和治疗结果产生负面影响。我们描述了一种新的50mg CFZ片剂在南非、印度和菲律宾儿童中的可接受性。方法:采用混合方法对莫西沙星和CFZ治疗儿童RR-TB的安全性和药代动力学进行评估。在4个时间点收集了36名参与者的定量数据。26对儿童/照料者的子样本参加了4次定性访谈。采用描述性统计和专题分析。研究结果:36名参与者(南非20岁,印度6岁,菲律宾10岁)的中位年龄为4.9岁。大多数患者(29/36)在改用片剂制剂之前接受了CFZ凝胶胶囊。50mg片剂在味觉(p=0.035)、嗅觉(p=0.035)和吞咽容易度(p=0.02)方面均优于凝胶胶囊。参与者描述片剂配方更容易管理/服用,没有挥之不去的气味或味道。对染色的关注有限。结论:新型50mg CFZ片可接受性较好,应尽可能优先应用于儿童。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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