No difference in leprosy treatment outcomes comparing 12- and 24-dose multidrug regimens: a preliminary study

Abstract

A comparative study was performed on the initial and final bacillary indexes of 213 multibacillary leprosy patients who received 12 doses (Group 1: 128 patients) or 24 doses (Group 2: 85 patients) of multidrug therapy (MDT/WHO) to measure the effectiveness of the two regimens. All patients were evaluated at treatment baseline, 12 months, and 24 months. The reduction in bacillary levels and mean bacillary indexes at 24 months was similar in the two groups. No statistical difference in reaction rates was observed between the two treatment regimens.

Fixed-duration therapy in leprosy: Limitations and opportunities

“…Now, the problem lies in determining the exact duration of MDT to achieve maximum results for MB cases. [202223]Operationally, a long duration of treatment is a major obstacle to successful implementation of MDT. Thus, a reduction in the length of treatment without jeopardizing effectiveness would potentially facilitate patient compliance and national program activities especially in remote rural areas where medical care is often scarce and frequently inaccessible to most patients.…”

Considerations on clinical trials of leprosy treatment: need of novel drug combinations

“…In Brazil, a strategic trial compared the WHO-MDT of fixed duration among 213 MB patients. The mean BIs and reaction rates of the patients who received 12 doses (n = 128) were similar to those treated with 24 doses (n = 85) of MDT [63]. This study and others were interpreted to indicate that the reduction to 12 doses did not compromise MDT effectiveness [45,64].…”

Use of anti-PGL-1 antibodies to monitor therapy regimes in leprosy patients

“…www.bjournal.com.br Braz J Med Biol Res 42 (10) 2009 with a preliminary study (15). This may reflect clearance of large numbers of bacilli in patients early during treatment (before 12 months), since there is a significant correlation between anti-PGL-1 levels and bacterial load.…”

“…Thus, our study compared the outcomes of treatment with 12-month vs 24-month MDT regimens in leprosy patients. Previous studies comparing the two regimens of leprosy treatment were based on clinical outcomes and BI variations during the course of treatment and after discharge (15). Since serology could provide a method to monitor leprosy patients under treatment (1), in the present study the outcome of leprosy treatment was studied not only on the basis of BI, but also on the basis of anti-PGL-1 levels.…”

“…Multibacillary (MB) patients should take the multidrug therapy (MDT-MB) with rifampicin (600 mg/month), clofazimine (300 mg/month and 50 mg/ day) and dapsone (100 mg/day) for 12 months instead of 24 months (14). However, this short-term regimen was considered to be unsafe by some physicians and professionals working with the leprosy control program, even though a preliminary study showed no difference in leprosy treatment outcomes between 12-and 24-month multidrug regimens (15). No treatment changes have been tried for paucibacillary (PB) patients, who continue to receive MDT-PB with rifampicin (600 mg/month) and dapsone (100 mg/ day) for 6 months (14).…”