L-arginine and Vitamin D Adjunctive Therapies in Pulmonary Tuberculosis: A Randomised, Double-Blind, Placebo-Controlled Trial

Study answer

What this study found

Neither L-arginine nor vitamin D improved microbiological or clinical outcomes when added to standard tuberculosis treatment. At week 4, culture negativity was 21/37 (57) in the L-arginine plus vitamin D arm, 27/39 (69) in the L-arginine plus placebo arm, and 23/38 (61) in the placebo L-arginine plus vitamin D arm. Pooled analyses also showed no meaningful advantage for L-arginine versus no L-arginine (48/76 [63.2%] versus 48/79 [60.8%]) or for vitamin D versus no vitamin D (44/75 [58.7%] versus 52/80 [65.0%]). There were no significant differences in week 8 culture conversion or clinical…

Study & population

Randomized, double-blind, placebo-controlled factorial trial in adults with newly diagnosed smear-positive pulmonary tuberculosis in Timika, Indonesia.

Intervention

Adults with pulmonary tuberculosis received standard anti-TB therapy plus adjunctive oral L-arginine hydrochloride 6 g daily for 8 weeks and/or oral cholecalciferol 50,000 IU at baseline and day 28 in a randomized factorial design.

Key limitation

The trial may have been underpowered to detect small benefits, so modest effects cannot be excluded.

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Original abstract