Rifampicine, ofloxacin and minocycline (ROM) in leprosy

Leprosy Mailing List – November 3^rd, 2010

Ref.:   Rifampicine, ofloxacin and minocycline (ROM) in leprosy

From: Kar H K, New Delhi , India

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Dear Dr Latif,

Greeting from India .  I refer to your message dated LML Nov. 3^rd, 2010.

ROM trial was conducted by WHO in India (a multi-centric randomized, double blind controlled clinical trial) to compare the efficacy of ROM with that of the WHO paucibacillary multidrug therapy (PB-MDT) in 1483 patients with one skin lesion and no peripheral nerve trunk involvement.  At 18 months follow up of 1381 patients who completed the study, marked improvement was  was observed in 51.7% in ROM as against 57.3% in WHO group while complete cure was observed in 46.95 of ROM group as compared to 54.7% in WHO group.  Six treatment failure in each group. (Indian J Lepr 1997;69:121-29).

In another study in Bangladesh, in 6.3 years follow up among 310 single skin lesion (SSL) PB cases treated during 1998-2000, 765 had complete clearance of lesions with relapse in 6 cases (3.6%).  The authors concluded that higher rates of relapse possibility should be kept in mind. (Lep Rev 2007;78:160).

WHO later initiated another clinical trial with intermittent drug regimens ROM in both multibacillary (MB) and PB cases with monthly once supervised doses for 3 or 6 doses for PB (1800 cases) and 12 or 24 doses for MB cases (1500 cases) in a multi-centric study in three countries (Guinea, Myanmar, Senegal). The long term results are awaited.

Regards,

Dr (Prof.) H K Kar
Consultant & HOD
Department of Dermatology, STD & Leprosy
P.G.I.M.E.R. and Dr Ram Manohar Lohia Hospital
Baba Kharag Singh Marg
New Delhi-110001