Lamprene (clofazimine)

Leprosy Mailing List – February 10^th, 2010

Ref.: Lamprene (clofazimine)

From: Pieter AM Schreuder, Maastricht, The Netherlands

---

Dear Salvatore,

Just visited the Cebu Skin Clinic, which is part of the Leonard Wood Memorial Foundation, Philippines . Excellent physicians - careful treatment of reactions, prevention of disabilities and a surveillance system which follows up patients for years after released from treatment (RFT). They told me that they see nowadays many more multibacillary patients with erythema nodosum leprosum (ENL) reaction after RFT, compared to the two years regimen of the past. Wim van Brakel is right saying that such statements should be based on proper research. As far as I understood a new research protocol has been finalised.

Again, the question is why an excellent drug like Lamprene is so easily disregarded? Are the good experiences with Lamprene in case of ENL in Southeast and East Asia so different from other parts of the world? Yes, indeed, it has its side-effects but in general much less than the other drugs in common use.

Lamprene is in most programs the only alternative to steroids in case of ENL. Especially in steroids-dependent ENL the corticosteroids can only be tapered off successfully (in the absence of Thalidomide) under coverage of high doses Lamprene.

We again have to stress that is imperative that loose Lamprene drugs should be made available to national programs in sufficient quantities. One problem seems to be that Lamprene is not available at the free market anymore?

Best regards,

Pieter AM Schreuder