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Effect of Pyrazinamide induced Hyperuricemia on Patient Compliance undergoing DOTS Therapy for Tuberculosis

Mahantesh A, Hanumantharayappa B, Madhava Reddy P, and Archana Swamy P

Hyperuricemia, with or without arthralgia, is the main adverse effects of pyrazinamide, a first line anti-TB drug. Hyperuricemia may lead to non-compliance to therapy, monitoring of uric acid and symptoms of arthralgia are necessary for patient compliance. A prospective open study was conducted on patients diagnosed with TB and were initiated with intensive phase of anti-tubercular treatment. Blood was withdrawn at 0, 2, and at 8th week to estimate serum uric acid level. Arthralgia was assessed and recorded during the same period. Uric acid levels were increased by the end of 2nd week. The observed mean serum uric acid at 0th week was 5.1 mg/dl which increased to 6.8 mg/dl and 6.6 mg/dl at 2nd and 8th week, respectively. 48.72% patients showed 25-50% increase in the uric acid level. 41.02% patients showed an increase in serum uric acid level beyond normal range (>7 mg/dl) and increased uric acid levels in 41.02% patients from 2nd and 8th week was non-significant. Despite an increase in serum uric acid levels beyond the normal range, arthralgia was not seen in TB patients who were on DOTS. thus, it is concluded that thrice weekly regimen of pyrazinamide is safe and effective therapy for treatment of TB