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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
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, Volume 101, No. 10, Year 2007
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Description
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. © 2007.
Authors & Co-Authors
Marlowe, S. N.S.
Unknown Affiliation
Leekassa, Ruth
Unknown Affiliation
Bizuneh, Elizabeth
Unknown Affiliation
Knuutilla, J.
Unknown Affiliation
Ale, P.
Unknown Affiliation
Bhattarai, B.
Unknown Affiliation
Sigdel, H.
Unknown Affiliation
Anderson, A. M.
Unknown Affiliation
Nicholls, Peter G.
Unknown Affiliation
Johnston, Atholl Edward Johnny
Unknown Affiliation
Holt, David W.
Unknown Affiliation
Lockwood, Diana N.J.
Unknown Affiliation
Statistics
Citations: 24
Authors: 12
Affiliations: 6
Identifiers
Doi:
10.1016/j.trstmh.2006.11.010
ISSN:
00359203
Research Areas
Noncommunicable Diseases
Study Design
Cohort Study