Effectiveness and safety of clofazimine and pentoxifylline in type 2 lepra reaction: a double‐blind, randomized, controlled study

Roy, Kaushik; Sil, Abheek; Das, Nilay Kanti; Bandyopadhyay, Debabrata

doi:10.1111/ijd.12793

Cited by 13 publications

(13 citation statements)

References 9 publications

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“…Systemic corticosteroids are the important drugs for the treatment of Type 1 reaction [12]. Presentation of Type 2 reactions can be varied ranging from mild disease to severe systematic disease [13] and are difficult to manage [14]. Type 2 reactions are also treated with analgesics and corticosteroids [8].…”

Section: Discussionmentioning

confidence: 99%

“…To avoid steroid-related adverse events, steroid sparing agent is required for the management of Type 2 lepra reactions [14]. One of such agents is chloroquine.…”

Section: Discussionmentioning

confidence: 99%

“…Cofazimine has been shown to be effective in the dose of 100 mg 3 times daily for 12 weeks [14]. The benefits of clofazimine include anti-inflammatory and steroid sparing effect [19].…”

Section: Discussionmentioning

confidence: 99%

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Retrospective analysis of prescriptions in the management of lepra reactions: Results of a single center study from tertiary hospital in Maharashtra

Kulkarni

Patil

Aathawale

2017

Asian J Pharm Clin Res

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Objective: To examine pattern of lepra reaction andmedicines used in the treatment of lepra reactions in a tertiary hospital. Material methods: In this retrospective study, prescriptions of patients treated for the lepra reactions were reviewed to find out prevalence of type 1 and type 2 reactions and medicines used in the treatment of lepra reactions. Results:A total of66 patients (male 59.1%; female 40.9%) with mean age of 36.6 (+13.1) years were included in the study. Multibacillary leprosy was present in 93.7% patients. A total of 39 (60%) patients had type 2 reaction whereas 26 (40%) had type 1 reaction. Mean number of medicines per patients was 7.5. Prednisolone was used in 62 (93.9%) patients with mean duration of 33.32 (+33.2) days whereas chloroquine was used in 52 (78.8%) patients for 36.6 (+27.9) days. Thalidomide was used in 25 (37.9%) patients. Analgesic and anti-inflammatory and anti-acidity drugs were used in 63 (95.4%) patients each whereas paracetamol was given to 41 (62.1%) patients. Antihistamine, antimicrobial agent and vitamins were given to 27 (40.9%), 27 (40.9%) and 35 (53.0%) patients respectively. Conclusion:Lepra 2 reaction is more common than lepra 1 reaction. Prednisolone and chloroquine are the two most commonly used medicines in the treatment of lepra reaction. Similarly, thalidomide, older drug has emerged as common treatment for lepra reaction.

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Section: Discussionmentioning

confidence: 99%

“…To avoid steroid-related adverse events, steroid sparing agent is required for the management of Type 2 lepra reactions [14]. One of such agents is chloroquine.…”

Section: Discussionmentioning

confidence: 99%

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Retrospective analysis of prescriptions in the management of lepra reactions: Results of a single center study from tertiary hospital in Maharashtra

Kulkarni

Patil

Aathawale

2017

Asian J Pharm Clin Res

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“…Pentoxifylline is used as 3 * 400 mg. In a study that compares the efficacy of clofazimine and pentoxifylline, pentoxifylline effectively reduced the initial severity, while clofazimine showed a slow but sustained effect [94]. Resistant erythema nodosum leprosum cases that treated successfully with methotrexate, infliximab and etanercept have been reported [95][96][97].…”

Section: Type 2 Reactionmentioning

confidence: 99%

An Update on the Epidemiology, Diagnosis and Treatment of Leprosy

Akpolat¹,

Akkus²,

Kaynak³

2019

Hansen's Disease - The Forgotten and Neglected Disease

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Leprosy is a granulomatous, chronic infection caused by Mycobacterium leprae that has been reported for than 2000 years. The infection primarily affects the skin and peripheral nerves.M. leprae is bacterium that cannot be cultured in vitro and transmission and pathophysiological data is still uncertain and limited. Today the prevalence of this ancient disease is declining in most around the world. This decline is a direct effect of widespread administration by public health workers of multidrug therapy. However, emerging despite the use of multidrug therapy, identifying and monitoring resistance are still necessary.

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“…There have been eight small, randomised treatment studies of ENL since the introduction of MDT [9–12, 15–17]. Only 269 patients were enrolled into these studies and just three studies with a total of 53 participants reported allocation concealment and blinding [15, 16]. Determining outcome measures for clinical studies in complex, multisystem disorders such as ENL is difficult.…”

Section: Introductionmentioning

confidence: 99%

A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale

Walker

Sales

Butlin³

et al. 2017

PLoS Negl Trop Dis

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ObjectivesWe wished to validate our recently devised 16-item ENLIST ENL Severity Scale, a clinical tool for measuring the severity of the serious leprosy associated complication of erythema nodosum leprosum (ENL). We also wished to assess the responsiveness of the ENLIST ENL Severity Scale in detecting clinical change in patients with ENL.MethodsParticipants, recruited from seven centres in six leprosy endemic countries, were assessed using the ENLIST ENL Severity Scale by two researchers, one of whom categorised the severity of ENL. At a subsequent visit a further assessment using the scale was made and both participant and physician rated the change in ENL using the subjective categories of “Much better”, “somewhat better”, “somewhat worse” and “much worse” compared with “No change” or “about the same”.Results447 participants were assessed with the ENLIST ENL Severity Scale. The Cronbach alpha of the scale and each item was calculated to determine the internal consistency of the scale. The ENLIST ENL Severity Scale had good internal consistency and this improved following removal of six items to give a Cronbach’s alpha of 0.77. The cut off between mild ENL and more severe disease was 9 determined using ROC curves. The minimal important difference of the scale was determined to be 5 using both participant and physician ratings of change.ConclusionsThe 10-item ENLIST ENL Severity Scale is the first valid, reliable and responsive measure of ENL severity and improves our ability to assess and compare patients and their treatments in this severe and difficult to manage complication of leprosy.The ENLIST ENL Severity Scale will assist physicians in the monitoring and treatment of patients with ENL. The ENLIST ENL Severity Scale is easy to apply and will be useful as an outcome measure in treatment studies and enable the standardisation of other clinical and laboratory ENL research.

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Effectiveness and safety of clofazimine and pentoxifylline in type 2 lepra reaction: a double‐blind, randomized, controlled study

Abstract: Pentoxifylline effectively reduces initial severity; clofazimine provides sustained improvement but acts slowly.

Cited by 13 publications

References 9 publications

Retrospective analysis of prescriptions in the management of lepra reactions: Results of a single center study from tertiary hospital in Maharashtra

Retrospective analysis of prescriptions in the management of lepra reactions: Results of a single center study from tertiary hospital in Maharashtra

An Update on the Epidemiology, Diagnosis and Treatment of Leprosy

A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale

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