Leprosy Mailing List – November 12, 2019
Ref.: (LML) Three drugs are unnecessary for treating paucibacillary leprosy—A critique of the WHO guidelines
From: Diana Lockwood, London, UK
Dear Pieter
"Three drugs are unnecessary for treating paucibacillary leprosy—A critique of the WHO guidelines" PLoS NTD
We posted a critique on the LML on December 23rd 2018 regarding the 2018 WHO guidelines suggesting that patients with paucibacillary (PB) leprosy should be treated with 3 drugs (rifampicin, dapsone and clofazimine) for six months rather than 2 (rifampicin and dapsone). We have now published these assessments as a commentary in PLoS NTD October 31st 2019.
We are sharing the link to this publication with LML readers. PLoS Negl Trop Dis 13(10): e0007671. https://doi.org/10.1371/
http://www.plosntds.org/
Our key points are that the reasoning underpinning this important change is based on insufficient evidence from a small number of patients in studies with significant design limitations.
Clofazimine causes significant adverse effects especially pigmentation. This is likely to increase stigma associated with leprosy. It will probably also worsen patient adherence with the new PB MDT regimen.
We urge everyone associated with leprosy medication, including national programme managers and NGOs working with leprosy treatments to read this evidence before switching to the 3 drug treatment regimen for PB cases.
Diana N. J. LockwoodID1*, Saba Lambert1, Aparna Srikantam2, Joydeepa Darlong3, V. V. Pai4, C. Ruth Butlin5, Barbara de BarrosID1, Edessa Negera1, Stephen L. WalkerID1
1 London School of Hygiene & Tropical Medicine, Faculty of Infectious Diseases, London, United Kingdom, 2 LEPRA-Blue Peter Public Health and Research Center, Hyderabad, India, 3 The Leprosy Mission Trust, New Delhi, India, 4 Bombay Leprosy Project, Mumbai, India, 5 The Leprosy Mission England and Wales, United Kingdom
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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