Marlowe, S.N.S., Leekassa, R., Bizuneh, E., Knuutilla, J., Ale, P., Bhattarai, B., Sigdel, H., Anderson, A., Nicholls, P.G., Johnston, A., Holt, D. and Lockwood, D.N.J.
Response to ciclosporin treatment in Ethiopian and Nepali patients with severe leprosy Type 1 reactions
Transactions of the Royal Society of Tropical Medicine and Hygiene, 101, (10), . (doi:10.1016/j.trstmh.2006.11.010).
Full text not available from this repository.
Leprosy type 1 reactions (T1R) are immune-mediated events with inflammation of peripheral nerves and skin. We report the clinical outcomes of a closely monitored open prospective trial in which eight Nepali and 33 Ethiopian patients with T1Rs were treated with an Indian generic formulation of ciclosporin (Cn; 5–7.5 mg/kg/day) for 12 weeks and followed up for 24 weeks after starting treatment. Outcomes were measured using a clinical severity score. Among the Nepalis, 75–100% improved in all acute clinical parameters; 67–100% patients maintained improvement, except for those with acute sensory nerve impairment among whom 67% relapsed after stopping treatment. The skin lesions of all Ethiopians on 5 mg/kg/day of Cn improved and 50–60% had peripheral nerve function improvement. Most Ethiopians needed a higher dose of Cn to improve nerve impairment and neuritis, and 50–78% of them developed worse clinical severity scores when Cn was stopped. Four Ethiopians and two Nepalis developed elevated serum creatinine levels on 7.5 mg/kg/day Cn, and three (9%) Ethiopians developed treatable hypertension. This suggests that Cn monotherapy is an effective treatment for severe T1R with few adverse effects. A dose of 5 mg/kg/day seems efficacious in Nepalis, but a higher dose may be required in Ethiopian patients.
Actions (login required)