Arginine Adjunctive Therapy in Active Tuberculosis
What this study found
Adjunctive L-arginine showed short-term benefits for several clinical and inflammatory outcomes, but it did not improve cough, sputum smear conversion, anemia, or final treatment success. At the end of the first month, constitutional symptoms were lower with arginine than placebo, 11 (34.4) versus 19 (61.3), P=0.032, and CRP was also lower, 8 (25) versus 16 (51.6), P=0.03. BMI < 18.5 was less frequent with arginine at both the first month, 4 (12.5) versus 11 (35.5), P=0.032, and the second month, 1 (3.1) versus 6 (19.4), P=0.04. No major side effects were reported, and nausea and diarrhea…
- Study & population
- Adults with newly diagnosed smear-positive pulmonary tuberculosis treated on an outpatient basis at DOTS clinics in Markazi province, Iran were randomized 1:1 to adjunctive L-arginine or placebo with standard anti-TB therapy.
- Intervention
- L-arginine hydrochloride 1000 mg capsules were taken orally, two capsules daily for 30 days, as adjunctive therapy to standard anti-tuberculosis treatment.
- Key limitation
- The active-arm sample was small, and supplementation lasted only 30 days, limiting confidence in longer-term clinical benefit.
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Open PDFOriginal abstract
Background. Dietary supplementation has been used as a mechanism to augment the immune system. Adjunctive therapy with L-arginine has the potential to improve outcomes in active tuberculosis. Methods. In a randomized clinical trial 63 participants with smear-positive pulmonary tuberculosis in Markazi Province of Iran were given arginine or placebo for 4 weeks in addition to conventional chemotherapy. The final treatment success, sputum conversion, weight gain, and clinical symptoms after one and two months were considered as primary outcomes and secondary outcomes were ESR, CRP, and Hg. Data were collected and analyzed with SPSS software (ver. 18). Results. Arginine supplementation reduced constitutional symptoms (P = 0.032) in patients with smear-positive TB at the end of the first month of treatment. Arginine treated patients had significantly increased BMI at the end of the first and second months of treatment (P = 0.032 and P = 0.04) and a reduced CRP at the end of the first month of treatment (P = 0.03) versus placebo group. Conclusion. Arginine is useful as an adjunctive therapy in patients with active tuberculosis, in which the effects are more likely mediated by the increased production of nitric oxide and improved constitutional symptoms and weight gain. This trial is registered with Clinical Trials Registry of Iran: IRCT201211179855N2.