Leprosy Mailing List – May 8, 2015
Ref.: (LML) Parenteral treatment of leprosy reactions
From: Wim van Brakel, Amsterdam, the Netherlands
Dear Pieter,
My response to the suggestion by Dr. Harun (LML, May 8, 2015) is that this would not ethical, since a randomised controlled trial has shown no additional benefit of parenteral high-dose treatment of leprosy reactions. I am particularly concerned with Dr Harun’s statement: “it is only to find out, whether by parenteral addition of corticosteroids, we can much sooner relieve the severe pain and agony caused by the leprosy reactions.”
If the trial done in Nepal were to be repeated – assuming it would pass ethical approval, which I doubt – it can only be done as a randomised controlled trial, otherwise Dr Harun’s question will remain unanswered. Signs and symptoms will be relieved through parenteral treatment. Evidence to date suggests that the improvement is not better or faster than with oral prednisolone. Perhaps Dr Harun intends to carry out a trial, but this is not clear from his statement.
With best wishes,
Wim van Brakel
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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