Abstract:

Isoniazid (INH) is one of the core drugs in the anti-tuberculosis (anti-TB) treatment regimens, and its catabolic speed is dependent on the activity of N-acetyltransferase-2 (NAT2). According to polymorphisms of the enzyme encoding gene NAT2, patients could be categorized as slow, intermediate or fast acetylators. The significant blood concentration difference was found in the deployment of uniform INH dosage for different TB patients, it could influence the treatment outcome and the occurrence of adverse drug reactions. To promote more scientific and canonical NAT2 gene polymorphism detection and acetylator type judgement, and then guide the appropriate isoniazid dosing for tuberculosis patients, experts in the field of tuberculosis treatment and pharmacology organized by Beijing Chest Hospital and the Editorial Board of Chinese Anti-tuberculosis Journal composed a consensus with the existing guidelines and published professional literature. This consensus includes the method of acetylator type categorization, the pharmacokinetic features, the influences on treatment outcome and adverse drug reactions, the dose adjustment principle of isoniazid for different acetylator types, and the important concerns on NAT2 polymorphism detection.

Key words: Tuberculosis, Isoniazid, Acetyltransferases, Polymorphism,single nucleotide, Therapeutic uses