Fw: Ref.: (LML) Fixed duration multidrug therapy (12 months) in leprosy patients with high bacillary load – Need to look beyond

 

Leprosy Mailing List – August 10,  2023

 

Ref.: (LML) Fixed duration multidrug therapy (12 months) in leprosy patients with high bacillary load – Need to look beyond

From:  Sunil Dogra, Chandigarh, India

 

 

Dear Pieter and colleagues,

 

 

We would like to thank Dr. Sinésio Talhari (LML, August 8, 2023) and Dr. Sandra Durães (LML, August 3, 2023) for their interest in our publication  (Narang T, Almeida JG, Kumar B, Rao PN, Frade MAC, et al. Fixed duration multidrug therapy (12 months) in Hansen's disease patients with high bacillary load – need to look beyond. Indian J Dermatol Venereol Leprol  doi: 10.25259/IJDVL_278_2023).

 

 

In response to their inquiry regarding the statement presented in the published paper on FDT in leprosy, which indicated a sevenfold increase in relapses in the 6-month regimen (U-MDT) compared to the 12-month treatment (FD-MDT), we would like to reference the data provided in the paper authored by Penna GO, et al. and published in PLoS Neglected Tropical Diseases (Volume 11, Issue 7, Article e0005725).

 

The authors of this paper have documented the following information regarding relapse rates: During the active follow-up period, four patients within the U-MDT group experienced relapse, resulting in a relapse rate of 2.6 per 1000 patients per year of active follow-up. Additionally, during the passive follow-up phase, three patients from the U-MDT group relapsed, along with one patient from the R-MDT group. This leads to a total of seven relapsed patients within the U-MDT group in comparison to one patient within the 12-month R-MDT group.

 

The authors have also indicated that the estimated relapse rate for the U-MDT group was 4.46 per 1000 people per year, while for the R-MDT group, it was 0.44 per 1000 people per year. However, it should be noted that the statistical significance of this difference was not established.

 

 

We have cited these figures from the aforementioned paper without delving into the intricate statistical calculations or the specifics of relapse rate determination.

 

As far treatment option of high BI multibacillary leprosy patients is concerned – we have suggested extending MDT MB beyond 12 months as only one of the strategies since it is likely to be logistically easy than other options as listed in our viewpoint.

 

Best Wishes & Regards,

 

 

Sunil Droga

 

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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