Acetylator status-guided rapid reintroduction of isoniazid in tuberculosis patients with drug-induced hepatotoxicity
Cynthia van Arkel, Ralf Stemkens, Cécile Magis-Escurra, Wouter Hoefsloot, Neeltje Carpaij, Jakko van Ingen, Reinout van Crevel, Arjan van Laarhoven, Rob Aarnoutse · 2026
Read Acetylator status-guided rapid reintroduction of isoniazid in tuberculosis patients with drug-induced hepatotoxicity by Cynthia van Arkel, Ralf Stemkens, Cécile Magis-Escurra, Wouter Hoefsloot, Neeltje Carpaij, Jakko van Ingen, Reinout van Crevel, Arjan van Laarhoven, Rob Aarnoutse (2026) in the Tower of Babel, a free online library of public-domain works preserved in clean, searchable text. No sign-up. The full text is served as a plain-text file at a predictable URL, where text is present: https://antarctic-labs.com/tower-of-babel/pmc-13266185.txt.
Description
Cynthia van Arkel and colleagues test metabolism-guided restarting of a tuberculosis drug after liver injury, published in 2026. Slow metabolisers of isoniazid face higher liver injury risk and treatment breaks. A Dutch referral centre phenotyped patients between 2021 and 2023. A single test dose revealed acetylator status even during liver problems.
Among forty-nine monitored patients, two-thirds were slow acetylators. Most liver injury cases were also slow acetylators. Higher drug exposure tracked with earlier injury onset. Restarting slow acetylators at lower doses shortened total treatment versus guidelines. The authors propose an even faster strategy that could save more than a month.
Catalog record
| CREATOR | Cynthia van Arkel, Ralf Stemkens, Cécile Magis-Escurra, Wouter Hoefsloot, Neeltje Carpaij, Jakko van Ingen, Reinout van Crevel, Arjan van Laarhoven, Rob Aarnoutse |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 28 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |