Efficacy and safety of rifampicin-based triple therapy for non-puerperal mastitis: A single-arm, open-label, prospective clinical trial

• Published in: International journal of infectious diseases 2024-03, Vol.140, p.25-30
• Main Authors: Zhou, Fei, Li, Huanjie, Wang, Fei, Liu, Liyuan, Yu, Lixiang, Xiang, Yujuan, Zheng, Chao, Huang, Shuya, Yu, Zhigang
• Format: Article
• Language: English
• Subjects: Granulomatous lobular mastitis; Medicine; Periductal mastitis; Safety
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2023.12.008

•Granulomatous lobular mastitis and periductal mastitis mainly affect young women.•Effective treatment options for NPM are still unclear and lack consensus.•Traditional antibiotic therapy is usually ineffective for NPM patients.•This single-center, single-arm, prospective clinical trial met primary endpoint.•The rifampicin-based triple therapy was effective and safe in patients with NPM. To assess the efficacy and safety of rifampicin-based triple therapy (rifampicin, isoniazid, and ethambutol) for treating NPM. This single-center, single-arm, prospective clinical trial was conducted at the Second Hospital of Shandong University (Jinan, China). Patients with pathologically diagnosed granulomatous lobular mastitis and periductal mastitis received triple drugs, i.e., rifampicin (450 mg/day), isoniazid (300 mg/day), and ethambutol (15 mg/kg/day), until complete response or the investigator decided to discontinue treatment. The primary endpoint was the complete response rate (CRR) assessed by the investigator. The secondary endpoints included the overall remission rate (ORR), recurrence rate (RR), and safety. A total of 218 patients were enrolled in the study between January 1, 2013 and October 31, 2020. With a median follow-up time of 48 months, the CRR and the ORR were 78.44% and 94.04%, respectively. While 13 patients (5.96%) demonstrated no response and 19 relapsed (8.72%). Adverse events (AEs) were not common. The most common AEs during treatment were liver dysfunction (1.83%), gastrointestinal reactions (1.83%), fatigue (1.83%), erythema (1.38%), and menstrual disorders (0.92%). Rifampicin, isoniazid, and ethambutol demonstrated promising response rates with acceptable safety profiles in patients with NPM. Further confirmatory trial is warranted in the future. The study was approved by the Ethics Committee of the Second Hospital of Shandong University and retrospectively registered at the China Clinical Trial Registration Center (registration number: ChiCTR2100049591).