Comparison of multiple drug therapy in leprosy
- Author:
Yap FBB
;
Awang T
;
Pubalan M
- Publication Type:Journal Article
- From:Malaysian Journal of Dermatology
2008;21(-):47-51
- CountryMalaysia
- Language:English
-
Abstract:
Introduction Multiple drug therapy (MDT) was utilized for the treatment of Hansen’s disease in Sarawak since 1989. MDT Sungai Buloh and MDT Sarawak were the 2 major MDT regimens used. Hence, we aim to compare the outcomes of MDT Sungai Buloh and MDT Sarawak.
Materials and Methods A retrospective review of 40 cases receiving MDT Sungai Buloh and MDT Sarawak from 1993 to 2006 was performed. Data regarding demographics and outcomes were collected and analysed. Primary outcome was cure and secondary outcomes were relapse, reactivation, death, leprosy reactions and deformities.
Results There were no statistically significant differences in the primary outcome among patients on MDT Sungai Buloh and MDT Sarawak (p=0.41) after adjustment for surveillance rate. We noted that
significantly more patients on MDT Sarawak (40.9%) were still under surveillance compared to MDT Sungai Buloh (5.6%, p=0.01). We also noted a higher rate of erythema nodosum leprosum (ENL) (16.7%)
and deformities (22.2%) in patients receiving MDT Sungai Buloh compared to 9.1% ENL and 9.1% deformity rate among those on MDT Sarawak. However, this did not reach statistical significance. Other secondary outcomes were not significantly different between the
two regimens. No recurrence was reported with the two treatment regimens. Subanalysis for multibacillary patients did not reveal any significant differences between the two regimens in the primary
outcome of cure after adjustment for surveillance rate (p=0.35). Both ENL and deformity rates of 25% each for MDT Sungai Buloh were higher than the rate of 13.3% each for MDT Sarawak although they did not reach statistical significance. Analysis for paucibacillary
patients did not show superiority of any one regimen.
Conclusion Both the MDT Sungai Buloh and MDT Sarawak were
effective in leprosy treatment. Selection of the best treatment regimens will depend on the cost effectiveness, ease of administration and duration of treatment that patients can tolerate.
